HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Uberto Bortolotti Aldo Milano Gaetano Thiene Francisco Guerra Alessandro Mazzucco Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bortolotti, U. Articles by Gallucci, V. Search for Related Content PubMed PubMed Citation Articles by Bortolotti, U. Articles by Gallucci, V.

Ann Thorac Surg 1987;44:139-144
© 1987 The Society of Thoracic Surgeons

---

Articles

Long-term Durability of the Hancock Porcine Bioprosthesis Following Combined Mitral and Aortic Valve Replacement: An 11-Year Experience

Departments of Cardiovascular Surgery, Pathology, and Radiology, University of Padua Medical School, Padua, Italy

Accepted for publication December 17, 1986.

^* Address reprint requests to Dr. Bortolotti, Istituto di Chirurgia Cardiovascolare, Via Giustiniani, 2, 35128 Padova, Italy

Long-term evaluation of patients undergoing combined mitral and aortic valve replacement (MVR + AVR) with a porcine bioprosthesis provides the opportunity for a direct comparison of the durability of the mitral versus the aortic porcine bioprosthesis in the same patient. From 1970 to 1983, 71 patients underwent MVR + AVR with Hancock porcine bioprostheses. There were 46 men an 25 women ranging in age from 21 to 64 years (mean, 47.5 ± 5 years). Sixteen patients (22.5%) died at operation. The survivors were followed from 0.2 to 11.5 years (mean, 5.7 ± 3 years). Duration of follow-up was 313 patient-years and was 100% complete. Overall late mortality was 6.7 ± 1.4% per patient-year (linearized incidence), and actuarial survival was 54.2 ± 8% at 11 years. Endocarditis occurred in 4 patients (linearized incidence of 1.3 ± 0.6% per patient-year); thromboembolic events were sustained by 4 patients (linearized incidence of 1.3 ± 0.6% per patient-year); the event was fatal in 1 patient. Actuarial freedom from thromboembolism was 90 ± 4.8% at 11 years. Reoperation for primary tissue failure was performed in 11 patients (linearized incidence of 3.5 ± 1% per patient-year) with no deaths; in 7 patients both bioprostheses were explanted, and in 4, only the mitral bioprosthesis was replaced. The durability of explanted aortic and mitral porcine bioprostheses was not significantly different, and the evaluation of seven pairs of explanted aortic and mitral bioprostheses showed similar amounts of calcification. Actuarial freedom from reoperation because of primary tissue failure was 44.6 ± 13.7% at 11 years.

Our experience indicates that (1) reoperation for primary tissue failure can be performed with low operative risk in patients who underwent MVR + AVR with porcine bioprostheses and (2) the durability of aortic and mitral porcine bioprostheses implanted in the same patient is similar.

This article has been cited by other articles:

				G. Rizzoli, S. Mirone, P. Ius, E. Polesel, T. Bottio, L. Salvador, C. Zussa, G. Gerosa, and C. Valfre Fifteen-year results with the Hancock II valve: A multicenter experience. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 602 - 609.e4. [Abstract] [Full Text] [PDF]

				A. M. Gillinov, E. H. Blackstone, D. M. Cosgrove III, J. White, P. Kerr, A. Marullo, P. M. McCarthy, and B. W. Lytle Mitral valve repair with aortic valve replacement is superior to double valve replacement J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1372 - 1387. [Abstract] [Full Text] [PDF]

				P. S. Brown Jr, C. S. Roberts, C. L. McIntosh, J. A. Swain, and R. E. Clark Relation between choice of prostheses and late outcome in double-valve replacement Ann. Thorac. Surg., March 1, 1993; 55(3): 631 - 640. [Abstract] [PDF]

				U. Bortolotti, A. Milano, G. Thiene, and A. Mazzucco Original expectations of the Hancock valve and 20 years of clinical reality Eur J Cardiothorac Surg, January 1, 1992; 6(Supplement_1): S75 - S78. [Abstract] [PDF]

				U. Bortolotti, A. Milano, L. Testolin, V. Tursi, A. Mazzucco, and V. Gallucci Influence of type of prosthesis on late results after combined mitral-aortic valve replacement Ann. Thorac. Surg., July 1, 1991; 52(1): 84 - 91. [Abstract] [PDF]