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Ann Thorac Surg 1978;26:303-316
© 1978 The Society of Thoracic Surgeons

Articles

Is the Hancock Porcine Valve the Best Cardiac Valve Substitute Today?

Julio C. Davila, M.D.*, Donald J. Magilligan, Jr., M.D., Joseph W. Lewis, Jr., M.D.

Division of Thoracic and Cardiac Surgery, The Henry Ford Hospital, Detroit, MI.

* Address reprint requests to Dr. Davila, A. Ward Ford Memorial Institute, Maple Hill, Wausau, WI 54401.

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 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.




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