Bio-Bentall Valve Classification
A Bio-Bentall valve is a tissue (bioprosthetic) valve, not a mechanical valve. The "bio" prefix specifically indicates biological tissue construction.
Valve Composition
The Bio-Bentall procedure involves replacing the aortic root with a bioprosthetic valve that consists of either:
- Porcine (pig) valve tissue, or
- Bovine (cow) pericardial tissue 1
These biological tissues are mounted on a stented frame and attached to a synthetic graft that replaces the ascending aorta 1.
Key Distinction from Mechanical Valves
Bioprosthetic valves fundamentally differ from mechanical valves in both structure and clinical implications:
- Mechanical valves have rigid metallic components (bileaflet disks, tilting disks, or ball-in-cage designs) that require lifelong warfarin anticoagulation 1
- Bioprosthetic valves use animal tissue that does not require long-term anticoagulation with warfarin, though aspirin 75-100 mg daily is reasonable 2
Clinical Implications of Bio-Bentall Selection
The primary advantage is avoiding mandatory anticoagulation:
- Bioprosthetic valves eliminate the bleeding risks associated with lifelong warfarin therapy 1, 2
- This is particularly important for patients with bleeding history or contraindications to anticoagulation 1
The primary disadvantage is limited durability:
- Bioprosthetic valves undergo structural valve degeneration over time due to calcification, tissue degradation, and immune-mediated processes 3
- Mechanical valves have superior structural stability and longevity 1
Common Pitfall to Avoid
Do not confuse the terminology: "Bio-Bentall" always refers to a biological/tissue valve, while a "mechanical Bentall" would use a mechanical valve prosthesis. The prefix "bio" is the definitive indicator of tissue valve construction 1.