Early Failure Secondary to Noncoronary

Structural degeneration is an important long-term disadvantage of biologic prostheses. However, early failure of these prostheses is uncommon and is usually caused by rapid cal-cification. We report the successful management of a rare case of early failure of a stent-less aortic bioprosthesis (within 4 months of implantation). The patient presented with severe noncalcific aortic regurgitation secondary to prolapse of the noncoronary leaflet. In consideration of the acute nature of failure in this new-generation bioprosthesis and its unclear cause, we believe that this report, albeit of a single case, warrants some attention. (Tex Heart Inst J 2012;39(5):676-9) A ortic valve replacement using stentless biological prostheses offers the ben-efits of good hemodynamics,1 without the requirement of prolonged anti-coagulation.2 Although their major drawback—structural degeneration in the long term—is well documented,3 bioprostheses rarely fail early, and, when they do, rapid calcification of the valve leaflets is the usual cause.4 We report the successful management of a rare case of early failure of a stentless aor-tic bioprosthesis within 4 months of implantation. The patient presented with severe noncalcific aortic regurgitation secondary to prolapse of the noncoronary leaflet. Case Repor