Mid- to Long-term Clinical Outcomes of Hancock II Bioprosthesis in Chinese Population
Related Experiment Video
Updated: Mar 28, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Yin Wang, Si Chen, Xing-Jian Hu
1Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.
Insights
The Hancock II bioprosthesis shows good durability and clinical outcomes in Chinese patients, with acceptable rates of death and adverse events over mid- to long-term follow-up.
Area of Science:
- Cardiovascular Surgery
- Bioprosthetic Heart Valves
- Clinical Outcomes Research
Background:
- Chinese patients have unique heart disease characteristics and treatment strategies compared to Western populations.
- Evaluating the performance of Hancock II bioprosthesis in this specific demographic is crucial.
Purpose of the Study:
- To assess the mid- to long-term clinical performance and durability of the Hancock II bioprosthesis in Chinese patients.
- To compare outcomes with existing data from other populations.
Main Methods:
- Retrospective review of 647 patients receiving Hancock II bioprosthesis from 2004-2013.
- Follow-up of 605 patients (96.2% rate) for a median of 56 months.
- Assessment of survival rates, reoperations, and valve-related morbidities using Kaplan-Meier analysis.
Main Results:
- Overall survival rates were 94.6% at 5 years and 82.7% at 10 years.
- Freedom from reoperation at 10 years was 86.8%, with specific rates for aortic, mitral, and double valve replacement.
- 10-year freedom from morbidities included thromboembolism (90.3%), hemorrhage (95.2%), endocarditis (97.5%), paravalvular leak (95.9%), and structural valve deterioration (94.6%).
Conclusions:
- Hancock II bioprosthesis demonstrates satisfactory mid- to long-term durability in the Chinese population.
- Clinical performance and adverse event rates are acceptable and comparable to existing international data.
Background:
Compared to the Western countries, Chinese patients present a special primary disease spectrum, diverse valvular pathogenesis, and different postoperational anticoagulation strategy. This research aimed to evaluate the mid- to long-term clinical performance of Hancock II bioprosthesis in the Chinese population.
Methods:
This study retrospectively reviewed all patients who received surgical treatments with at least one Hancock II bioprosthesis implantation from January 2004 to December 2013 at a single center in China. Totally 647 patients were included in the clinical evaluation, and 629 patients were successfully discharge, among whom 605 patients were completely followed-up. The follow-up rate was 96.2%. The mean and median follow-up time was 62.0 ± 59.0 and 56.0 months, respectively. Postoperative outcomes of survival rates, reoperations and valve related morbidities were assessed. Continuous and categorical variables were compared using the t -test and Chi-square test, respectively. Survival and freedom from adverse events were calculated by using a Kaplan-Meier method.
Results:
The overall in-hospital mortality was 2.8% (18/647) while there were 34 deaths (5.6%, 34/605) in the follow-up stage after discharge. The overall survival rate was 94.6% and 82.7% at 5 years and 10 years, respectively. The cumulative survival rate of 10 years was 82.8% in AVR group, 84.4% in MVR group, and 78.4% in DVR group. The overall rate of freedom from reoperations was 95.5% at 5 years and 86.8% at 10 years. The freedom from reoperation at 10 years was 87.0%, 88.1%, and 84.0% in AVR, MVR, and DVR group, respectively. The freedom from morbidities at 10 years was: 90.3% for thromboembolism, 95.2% for hemorrhage, 97.5% for prosthesis endocarditis, 95.9% for paravalvular leak, and 94.6% for structural valve deterioration, respectively.
Conclusions:
Hancock II bioprosthesis exhibited a satisfactory mid- to long-term durability and promising clinical performance in the Chinese population. The occurrence rates of death and other adverse events in this single-center study were overall coincident and quite acceptable when compared with existing data.
