Is the Hancock porcine valve the best cardiac valve substitute today?
Valve replacement with the Hancock stabilized glutaraldehyde porcine aortic valve has been accomplished in 454 patients. Hospital mortality (influenced by a high proportion of patients in New York Heart Association Functional Class IV) was 17.6% (80/454). The first 221 patients discharged from hospital were followed for 36 to 75 months after valve replacement. There have been 26 late deaths among these patients; 88% (195/221) are alive. Of these 221 patients, 185 had single-valve replacement, (125 mitral and 60 aortic), and 36 underwent multiple-valve replacement. There have been 260 valves at risk up to 6 1/4 years, which is equivalent to 12,984.5 valve-months or 1,082 valve-years. Average follow-up is 4.16 years. There have been 13 valve failures in 10 patients. In 4 patients endocarditis was proved to be the cause of failure, and in 5 it was suspected; in 1 patient the failure the failure is unexplained. The pathological similarity between those in whom infection was documented and the other 5 is remarkable and raises the question of whether low-grade infections may be the cause of certain types of valve failure.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D002648:Child; D004697:Endocarditis, Bacterial / Q000150:complications / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D013923:Thromboembolism / Q000209:etiology