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. 1989 Oct;210(4):435–443. doi: 10.1097/00000658-198910000-00003

Fifteen-year experience with 1678 Hancock porcine bioprosthetic heart valve replacements.

L H Cohn 1, J J Collins Jr 1, V J DiSesa 1, G S Couper 1, P S Peigh 1, W Kowalker 1, E Allred 1
PMCID: PMC1357917  PMID: 2802832

Abstract

The Hancock porcine valve was the first commercially available biologic heart valve and has been in continuous use at the Brigham and Women's Hospital since January 1972. Through December 1987 we implanted 1678 valves in 1533 patients (885 male; 648 female; 17 to 95 years of age, with a mean of 60 years). There were 825 aortic valve replacements (AVR), 562 isolated mitral valve replacements (MVR), and 146 aortic mitral replacements (DVR). Ninety-four per cent of the patients were functional class III or IV. Associated coronary bypass was done in 25% of patients. Four per cent of patients were lost to follow up during a 1- to 16-year period with a mean of 6 years. Morbidity and mortality rates on a actuarial basis were calculated 10 and 15 years after operation for AVR, MVR, and DVR. The data indicates that the probability of reoperation for structural valve failure is quite reasonable as of 10 years, but from 10 to 15 years the numbers sharply fall off so that the probable effective life of the valve is 10 years. However in the elderly age group (equal to or greater than 70 years of age) the incidence of structural valve degeneration is markedly diminished, making this an ideal valve substitute for the elderly. It is also an ideal valve substitute in any patient who has a contraindication to long-term anticoagulation because of current medical or surgical problems.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BARRATT-BOYES B. G. HOMOGRAFT AORTIC VALVE REPLACEMENT IN AORTIC INCOMPETENCE AND STENOSIS. Thorax. 1964 Mar;19:131–150. doi: 10.1136/thx.19.2.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Carpentier A., Lemaigre G., Robert L., Carpentier S., Dubost C. Biological factors affecting long-term results of valvular heterografts. J Thorac Cardiovasc Surg. 1969 Oct;58(4):467–483. [PubMed] [Google Scholar]
  3. Cohn L. H., Allred E. N., Cohn L. A., Austin J. C., Sabik J., DiSesa V. J., Shemin R. J., Collins J. J., Jr Early and late risk of mitral valve replacement. A 12 year concomitant comparison of the porcine bioprosthetic and prosthetic disc mitral valves. J Thorac Cardiovasc Surg. 1985 Dec;90(6):872–881. [PubMed] [Google Scholar]
  4. Cohn L. H., Allred E. N., DiSesa V. J., Sawtelle K., Shemin R. J., Collins J. J., Jr Early and late risk of aortic valve replacement. A 12 year concomitant comparison of the porcine bioprosthetic and tilting disc prosthetic aortic valves. J Thorac Cardiovasc Surg. 1984 Nov;88(5 Pt 1):695–705. [PubMed] [Google Scholar]
  5. Cohn L. H., Mudge G. H., Pratter F., Collins J. J., Jr Five to eight-year follow-up of patients undergoing porcine heart-valve replacement. N Engl J Med. 1981 Jan 29;304(5):258–262. doi: 10.1056/NEJM198101293040503. [DOI] [PubMed] [Google Scholar]
  6. DURAN C. G., GUNNING A. J. HETEROLOGOUS AORTIC-VALVE TRANSPLANTATION IN THE DOG. Lancet. 1965 Jul 17;2(7403):114–115. doi: 10.1016/s0140-6736(65)92227-0. [DOI] [PubMed] [Google Scholar]
  7. DiSesa V. J., Cohn L. H., Collins J. J., Jr, Koster J. K., Jr, VanDevanter S. Determinants of operative survival following combined mitral valve replacement and coronary revascularization. Ann Thorac Surg. 1982 Nov;34(5):482–489. doi: 10.1016/s0003-4975(10)62992-x. [DOI] [PubMed] [Google Scholar]
  8. Edmunds L. H., Jr, Cohn L. H., Weisel R. D. Guidelines for reporting morbidity and mortality after cardiac valvular operations. J Thorac Cardiovasc Surg. 1988 Sep;96(3):351–353. [PubMed] [Google Scholar]
  9. Edmunds L. H., Jr Thromboembolic complications of current cardiac valvular prostheses. Ann Thorac Surg. 1982 Jul;34(1):96–106. doi: 10.1016/s0003-4975(10)60862-4. [DOI] [PubMed] [Google Scholar]
  10. Foster A. H., Greenberg G. J., Underhill D. J., McIntosh C. L., Clark R. E. Intrinsic failure of Hancock mitral bioprostheses: 10- to 15-year experience. Ann Thorac Surg. 1987 Dec;44(6):568–577. doi: 10.1016/s0003-4975(10)62137-6. [DOI] [PubMed] [Google Scholar]
  11. Gallo I., Nistal F., Blasquez R., Arbe E., Artiñano E. Incidence of primary tissue valve failure in porcine bioprosthetic heart valves. Ann Thorac Surg. 1988 Jan;45(1):66–70. doi: 10.1016/s0003-4975(10)62400-9. [DOI] [PubMed] [Google Scholar]
  12. Magilligan D. J., Jr, Lewis J. W., Jr, Tilley B., Peterson E. The porcine bioprosthetic valve. Twelve years later. J Thorac Cardiovasc Surg. 1985 Apr;89(4):499–507. [PubMed] [Google Scholar]
  13. McGoon D. C. The risk of thromboembolism following valvular operations: how does one know? J Thorac Cardiovasc Surg. 1984 Nov;88(5 Pt 1):782–786. [PubMed] [Google Scholar]
  14. Milano A. D., Bortolotti U., Mazzucco A., Guerra F., Stellin G., Talenti E., Thiene G., Gallucci V. Performance of the Hancock porcine bioprosthesis following aortic valve replacement: considerations based on a 15-year experience. Ann Thorac Surg. 1988 Aug;46(2):216–222. doi: 10.1016/s0003-4975(10)65902-4. [DOI] [PubMed] [Google Scholar]
  15. Milano A., Vouhé P. R., Baillot-Vernant F., Donzeau-Gouge P., Trinquet F., Roux P. M., Leca F., Neveux J. Y. Late results after left-sided cardiac valve replacement in children. J Thorac Cardiovasc Surg. 1986 Aug;92(2):218–225. [PubMed] [Google Scholar]
  16. Oyer P. E., Stinson E. B., Reitz B. A., Miller D. C., Rossiter S. J., Shumway N. E. Long-term evaluation of the porcine xenograft bioprosthesis. J Thorac Cardiovasc Surg. 1979 Sep;78(3):343–350. [PubMed] [Google Scholar]
  17. Pupello D. F., Bessone L. N., Hiro S. P., Lopez-Cuenca E., Glatterer M. S., Jr, Ebra G. The Carpentier-Edwards bioprosthesis: a comparative study analyzing failure rates by age. J Card Surg. 1988 Sep;3(3 Suppl):369–374. doi: 10.1111/jocs.1988.3.3s.369. [DOI] [PubMed] [Google Scholar]
  18. ROSS D. N. Homograft replacement of the aortic valve. Lancet. 1962 Sep 8;2(7254):487–487. doi: 10.1016/s0140-6736(62)90345-8. [DOI] [PubMed] [Google Scholar]
  19. STARR A., EDWARDS M. L. Mitral replacement: clinical experience with a ball-valve prosthesis. Ann Surg. 1961 Oct;154:726–740. doi: 10.1097/00000658-196110000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Schoen F. J., Collins J. J., Jr, Cohn L. H. Long-term failure rate and morphologic correlations in porcine bioprosthetic heart valves. Am J Cardiol. 1983 Mar 15;51(6):957–964. doi: 10.1016/s0002-9149(83)80173-8. [DOI] [PubMed] [Google Scholar]

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