Calcification is a major cause of clinical failure of bioprosthetic and other tissue cardiac valve substitutes.The mechanism of calcification of cardiac valve substitutes is quite complex and has a variety of determinants,involving reaction of calcium-containing extracellular fluid with membrane-associated phosphorus to yield calcium phosphate mineral deposits.The most promising anticalcification strategies have included binding of calcification inhibitors to glutaraldehyde fixed tissue,removal or modification of calcifiable components,modification of glutaraldehyde fixation and use of tissue cross linking agents other than glutaraldehyde.This article reviews current progress toward the research of calcification and anticalcification strategies that are under investigation either in advanced animal models or in clinical trials.