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Insights
This study evaluated Hancock prosthesis in 318 patients, finding good survival rates and functional improvement. Prosthesis complications and thromboembolic events were observed, with lower rates in aortic positions.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Clinical Outcomes Research
Context:
- Hancock prosthesis use in mitral and/or aortic positions between 1974-1976.
- Study included 318 patients with a maximal follow-up of 5.58 years (1,129.8 patient-years).
Purpose:
- To report the outcomes, complications, and survival rates of Hancock prosthesis implantation.
- To analyze the incidence of prosthesis complications and thromboembolic events in different valve positions.
Summary:
- Hospital mortality was 10.3%. Late mortality rates per patient-year were 1.18% (mitral), 1.40% (aortic), and 3.82% (mitro-aortic).
- Survival at 67 months: 89.5% (aortic), 85% (mitral), 70% (mitro-aortic).
- Prosthesis complications occurred in 12 patients; 15 thromboembolic events occurred, none fatal. Most survivors (99.3%) showed functional improvement.
Impact:
- Provides long-term data on Hancock prosthesis performance, informing clinical decision-making.
- Highlights the importance of considering valve position when assessing risks and benefits of prosthetic devices.
- Contributes to understanding the safety and efficacy of early prosthetic valve technology.
Abstract:
We show the results obtained with 318 patients who had a Hancock prosthesis implanted in mitral and/or aortic positions, between June of 1974 and December of 1976. The maximal follow-up period (January 1980) was of 5.58 years, with a total follow-up of 1,129.8 patient years. The hospital rate of mortality was 10.3% (33/318), with 19 late deaths, which gives a linear index of late mortality for mitral, aortic, and mitro-aortic patients of 1.18%, 1.40%, and 3.82% patient-year respectively. The actuarial analysis of the results show a survival rate at 67 months of 89.5% for the aortics, 85% for the mitrals, and 70% for the mitro-aortics. In 12 occasions prosthesis complications developed (7 ruptures, 3 thrombosis, and 2 prosthesic disfunctions), which represents an incidence of 0.28%, 0.84%, and 2.72% patient-years for the aortic, mitral, and mitro-aortic patients respectively. Of the 15 thromboembolic accidents that developed, none had a fatal outcome, and their incidence for the aortic, mitral, and mitro-aortic patients was 0.28%, 2.19%, and 5.46% patient-year respectively. The actuarial analysis of thromboembolism shows that 98.9%, 98.3%, and 91,3% of aortic, mitro-aortic, and mitral patients respectively, were free of thromboembolism at 67 months postoperatively. The 99.3% of the patients that survived surgery have improved functionally, 80.4% having no symptoms from the cardiovascular point of view.