title: Isolated mitral valve replacement with the Hancock porcine bioprosthesis in rheumatic heart disease: analysis of 213 operative survivors followed up 4.5 to 8.5 years.
abstract: An analysis is presented of 236 patients aged greater than or equal to 20 years who underwent isolated mitral valve replacement for rheumatic heart disease with a glutaraldehyde Hancock bioprosthesis from June 1974 through June 1978. Of 213 patients discharged from the hospital, 3 were lost to follow-up study and are excluded from the analysis. The range of follow-up of the surviving patients was 54 to 102 months. There were 17 late deaths, an incidence of 1.3% per patient-year. The actuarial probability of survival of all patients at 102 months, excluding hospital mortality, is 88 +/- 6%. There were 24 thromboembolic events in 22 patients (1.8% per patient-year); none was fatal, and 3 patients were receiving coagulant therapy at the time. The probability of freedom from thromboembolism at 8.5 years is 84 +/- 9%. Primary tissue failure occurred in 17 patients (1.3% per patient-year). Average duration of the explanted valves was 70 months (range 55 to 90). Reoperation was undertaken in the 17 patients 2 days to 63 months (mean 9 months) after the appearance of a new murmur and 2 days to 23 months (average 4 months) after the onset of worsening symptoms. The probability of being free from primary tissue valve failure at 8.5 years of follow-up is 87 +/- 7%. Currently, 14 patients have valve dysfunction on the basis of the appearance of a new murmur 20 to 89 months after operation (average 5.2 years).(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D012214:Rheumatic Heart Disease / Q000150:complications*