Previously, we used magnetic resonance (MR) imaging to reconstruct, three-dimensionally, porcine bioprosthetic heart valve (PBHV) cusps and showed that accelerated testing induced changes in cuspal shape, including focal regions of high curvature. In this study, the MR technique was applied to an expanded valve database. Results confirmed that PBHV cusps undergo a continuous, non-recoverable deformation with accelerated testing. In addition, in one cusp structural information obtained was mapped two-dimensionally by small-angle light scattering back to the three-dimensional cuspal surface. Results from that cusp demonstrated a strong spatial correlation between elevated curvatures and structural damage. We conclude that the observed changes in cuspal shape accelerate PBHV damage through an increase in flexural strains, induced by an increase in curvature reversal during valve operation.