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Heart valve replacement with the Hancock bioprosthesis. Analysis of long-term results
Insights
The Hancock "SGP" bioprosthesis shows durability and effectiveness in heart valve replacement, with low rates of complications like insufficiency and thromboembolism, supporting its use in various positions.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
Background:
- The Hancock
- SGP
- bioprosthesis has been utilized for heart valve replacement since 1970.
- Long-term outcomes of this specific bioprosthetic device require thorough evaluation.
Purpose of the Study:
- To analyze the long-term clinical outcomes, survival rates, and complication incidence associated with the Hancock
- SGP
- bioprosthesis.
- To assess the durability and functional performance of glutaraldehyde-preserved porcine valves in cardiac surgery.
Main Methods:
- Retrospective analysis of 564 patients undergoing single or multiple heart valve replacement using the Hancock
- SGP
- bioprosthesis between March 1970 and May 1976.
- Evaluation of clinical improvement, survival data, and complications including insufficiency, endocarditis, stenosis, and thromboembolism.
- Hemodynamic re-evaluation in a subset of patients to assess prosthesis function.
Main Results:
- A total of 629 xenografts were implanted in 564 patients.
- Low incidence of significant valve insufficiency (3 patients) and reoperations (4 patients for endocarditis or stenosis).
- Thromboembolic episodes occurred in 1.76% of patients, primarily early postoperatively. Hemodynamic assessment confirmed proper prosthesis function in mitral and aortic positions.
Conclusions:
- The glutaraldehyde-preserved porcine valve demonstrates durability and acceptable long-term performance.
- The Hancock
- SGP
- bioprosthesis is a viable option for heart valve replacement across all valvular positions.
- Clinical outcomes support the continued use of this bioprosthetic device.
Abstract:
Between March 1970 and May 1976, 564 patients have undergone single or multiple heart valve replacement with the Hancock "SGP" bioprosthesis in our institution. Of these patients, 335 had single mitral, 102 aortic, one tricuspid, and 126 double or triple valve replacement, for a total of 629 xenografts. The long-term results, in terms of clinical improvement, survival, and complications, have been analyzed. Significant valve insufficiency secondary to primitive tissue alterations occurred in three patients, while reoperations were required in two for endocarditis and in two others for mitral stenosis caused by tissue ingrowth. We found that thromboembolic episodes occurred mainly in the early postoperative period up to the third month in 10 cases (1.76%). Three patients suffered peripheral embolization during the late follow-up period. Anticoagulants were not administered beyond 3 months postoperatively. Hemodynamic re-evaluation has been performed in 42 patients and the prosthesis has been shown to function properly either in the mitral or the aortic position. The data available to date indicate that the glutaraldehyde-preserved porcine valve is durable and we feel that its use is warranted in any valvular position.