Hemodynamic valve deterioration (HVD) of surgically implanted aortic bioprostheses on Doppler echocardiography is independently associated with a marked increase in the risk of valve reintervention or mortality, according to a study published online July 9, 2018 in the Journal of the American College of Cardiology. Leaflet calcification, insulin resistance and dysmetabolic profile were predictors of HVD.