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No animal studies were carried out by the authors for this article. The samples used in these studies were deidentified of all patient data and were deemed exempt from institutional review board oversight by the University of Michigan IRB under the basis all data were coded biological specimen or coded private information in nature that could not be linked to human subjects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Subjects had consented to use removed plaque and valve components for general research purposes, not specifically for this research\u2014which underwent IRB submission at the University of Michigan with the determination of \"Not IRB regulated\" and involved only samples of coded biological specimen and coded private information.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate\/Consent to Publish"}},{"value":"Lucas Su Chen, Gabriel Koh, Yak-Nam Wang, Ga Won Kim, Zorawar Singh, Adrienne Lehnert, Adam Maxwell, Hitinder Gurm, and Robert Miyaoka declare no conflicts of interest\/competing interests including financial and non-financial interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}