Related Experiment Videos
Late postoperative anatomic observations after insertion of Hufnagel caged-ball prostheses in descending thoracic
Insights
Long-term survival with Hufnagel prostheses shows no device degeneration. These Hufnagel descending aortic prostheses are safe for patients, even after many years.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Medical Device Engineering
Background:
- The Hufnagel prosthesis was the first successful artificial cardiac valve used in humans.
- Long-term outcomes of Hufnagel prostheses in the descending thoracic aorta are not well-documented.
Purpose of the Study:
- To evaluate the long-term clinical performance and durability of Hufnagel prostheses.
- To assess the safety and necessity of removing Hufnagel prostheses during subsequent cardiac surgeries.
Main Methods:
- Clinical and necropsy observations of two patients with Hufnagel prostheses implanted for 11 and 13 years.
- Literature review of previously reported cases involving Hufnagel descending aortic prostheses.
Main Results:
- No evidence of prosthetic degeneration, thrombosis, or intravascular hemolysis was found in the two patients.
- Previous reports also showed no prosthetic-related complications in long-term survivors (>3 years).
Conclusions:
- Hufnagel descending aortic prostheses demonstrate excellent long-term durability and safety.
- Removal of these prostheses is generally not recommended due to significant risks and lack of observed complications.
Abstract:
Clinical and necropsy observations are described in two patients who died 11 and 13 years, respectively, after implantation of Hufnagel prostheses (the first ever used successfully in humans to treat cardiac valve disease) in descending thoracic aorta. Despite the long implantation periods, there was no evidence of prosthetic degeneration or thrombosis or intravascular hemolysis. Although approximately 4000 Hufnagel descending aortic prostheses were distributed by the manufacturer for human use, data in only 55 patients in whom these prostheses were inserted were found in previous publications, and 26 of them had died. Of the 13 late deaths previously reported, no evidence of prosthetic degeneration or thrombosis was described in the three patients surviving greater than 3 years (8, 10, 12.5 years, respectively). Since neither our patients nor any of the other three reported long-term survivors had prosthetic-related complications and since the dangers of excising the descending aortic prosthesis are considerable, it appears most reasonable, as a rule, not to remove the descending aortic prosthesis at any time in these patients if aortic valve replacement is subsequently performed.