Hi, Neo, I've read some articles now about NOTCH1. There are two versions of NOTCH1 identified so far. The normal one produces a binding protein that helps in wound healing. The mutated version does the same thing but it produces far more than is needed for healing. I can produce 50 times more. This overproduction of the binding protein appears to cause the calcification of aortic valves. The protein appears to cause calcification of any biological leaflets although more research will need to be done to understand the process better. If this is true, and one has the mutated form of NOTCH1, any biological leaflets are likely to calcify. If this genetic mutation does prove to be a major cause of aortic stenosis, then its unlikely that diet or exercise could have any significant effect on the progress of calcification. Fortunately, several groups of researchers are interested in tracking down the relationships of NOTCH1 to aortic stenosis. The group at Vanderbilt University is actually studying a new drug to treat rheumatoid arthritis when they realized that their drug shuts down NOTCH1. So, its possible in a few years and, maybe, not all that many years there could actually be a drug on the market to keep our bioprosthetic valves going for much longer.