Previous research has suggested that the structural deterioration in porcine bioprosthetic heart valves (BHV) may be correlated with the regions of high tensile and bending stresses acting on the leaflets during opening and closing[1, 2]. Stress concentrations within the cusp can either directly accelerate tissue structural fatigue damage, or initiate calcification by causing structural disintegration, enabling multiple pathways of calcification that can lead to valve failure[3,4]. In the case of bovine pericardial heart valve prostheses, structural failure of the leaflets is rare but calcification has been observed. Although details of the process are unclear, it is generally assumed that the design of the pericardial valve, which gives a stress-reduced state of the leaflets, is likely to provide improved performance in long-term applications.

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