Calcific Deposits Developing in a Bovine Pericardial Bioprosthetic Valve

SUMMARY Calcific deposits, localized in a thin layer of thrombus covering the cuspal surfaces, were pres-ent 3 days after implantation in a valved pulmonic conduit that contained an Ionescu-Shiley bovine pericardial valve and was placed in a 29-year-old man with double outlet right ventricle, valvular and infundibular pulmonic stenosis, and ventricular septal defect. Factors that may have contributed to such a rapid calcification were the relatively young age of the patient, the development of acute renal insufficiency postoperatively, and the ad-ministration of large amounts of calcium chloride intravenously during blood transfusions and during episodes of cardiac arrest. CALCIFICATION of bioprosthetic cardiac valves can lead to prosthetic stenosis, regurgitation or both.1 10 Calcific deposits usually produce valvular dysfunction only after the bioprostheses have been in place for several years.1 In some patients, however, calcific deposits have developed within a few months after implantation.1-6, 10 In one exceptional patient,4 a porcine bioprosthetic valve had to be removed be