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Statins and macrophages in bioprosthetic valve degeneration. Central Message Statins may decrease calcification of biologic tissue valve prostheses. Macrophages may play a key role in biologic valvular tissue longevity.

A neonate with antenatally diagnosed severe aortic valve stenosis, left ventricular outflow tract obstruction, left ventricular endocardial fibroelastosis, and severe mixed mitral valve disease was admitted to our center for balloon aortic valvuloplasty. On day 49, we performed a Ross-Konno procedure and mitral valve replacement on the baby, whose weight was 3.4 kg. Right ventricle-to-pulmonary artery continuity was restored with a handmade trileaflet Gore-Tex conduit. We used a handmade cylindrical prosthesis made from decellularized equine pericardium in the mitral position. We observed improvement in left ventricular function and good performance of aortic, pulmonary, and mitral prostheses at four months of follow-up.

Schematic of the TWIST1/MATTL3 pathway in osteogenic differentiation of interstitial cells. CENTRAL MESSAGE A novel therapeutic target using the TWIST pathway and valvular interstitial cells may prevent aortic valve calcification.

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