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The Annals of Thoracic Surgery, Vol 38, 571-578, Copyright © 1984 by The Society of Thoracic Surgeons
V Gallucci, U Bortolotti, A Milano, C Valfre, A Mazzucco and G Thiene
Four hundred seventy-six patients underwent isolated mitral valve
replacement (MVR) with the glutaraldehyde-preserved porcine Hancock
bioprosthesis from March, 1970, through December, 1981. There were 312
female and 164 male patients ranging in age at operation from 9 to 68 years
(average, 53 years). Associated surgical procedures were performed in 35
patients. Hospital mortality was 13%, the main cause of death being
low-output syndrome. The survivors were followed from 1.6 to 13.2 years
(mean, 5.2 years). Cumulative duration of follow-up is 2,180 patient-years
and is 97% complete. Overall late mortality is 3.1 +/- 0.3% per
patient-year, and actuarial survival is 73.8 +/- 3.4% at 13 years. Embolic
accidents occurred in 45 patients and were fatal in 13; the linearized
incidence of postoperative systemic thromboemboli is 2.1 +/- 0.3% per
patient-year. Reoperation was necessary in 49 patients: in 4 because of
valve endocarditis, with 3 deaths; in 6 because of perivalvular leak, with
no deaths; in 2 because of left atrial thrombosis; and in 37 because of
valve dysfunction due to primary tissue failure, caused mainly by calcific
degeneration of the tissue, with 5 operative deaths. Actuarial freedom from
primary tissue failure is 58 +/- 6.6% at 13 years. Extended follow-up after
MVR with the Hancock bioprosthesis confirms the satisfactory performance
and low thrombogenicity of this device up to 13 years after
operation.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Isolated mitral valve replacement with the Hancock bioprosthesis: a 13- year appraisal
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