Background. To define the long-term results of 331 standard Hancock porcine bioprostheses implanted in the mitral position between 1973 and 1980. Methods. Of 331 patients (225 male patients, 68%), mean age 49 +/- 10 years (range 14 to 69 years), 88% were in New York Heart Association functional class III or IV and 77% were in atrial fibrillation. Follow-up time extended more than 20 years (mean 13.9 years, range 0.3 to 24.7 years) for a total of 4,601 patient-years. Results. Overall operative mortality was 6.3%. At 5, 10, 15, and 20 years, the actuarial survival rate of patients were 71% +/- 2%, 46% +/- 3%, 30% +/- 3%, and 22% +/- 2%, respectively. Actuarial estimates of freedom from structural valve deterioration were 95% +/- 1%, 67% +/- 3%, 32% +/- 3%, and 14% +/- 3%; from reoperation were 96% +/- 1%, 72% +/- 3%, 36% +/- 4%, and 18% +/- 4%; from thromboembolism were 89% +/- 2%, 82% +/- 3%, 74% +/- 4%, and 51% +/- 2%; and from anticoagulant-related hemorrhage were 98% +/- 1%, 96% +/- 1%, 91% +/- 1%, and 86% +/- 4%. Estimates of freedom from all valve-related mortality at 5, 10, 15, and 20 years were 89% +/- 2%, 76% +/- 3%, 64% +/- 4%, and 48% +/- 4%. Multivariate analysis showed younger age to be a significant risk factor for reoperation. Age at operation did not correlate with structural valve deterioration. Conclusions. The long-term results with the standard Hancock bioprosthesis implanted in the mitral position appear satisfactory, particularly up to 15 years from implantation. Protection from stroke, anticoagulant hemorrhage, and endocarditis was good.

Over twenty-year follow-up of the standard Hancock porcine bioprosthesis implanted in the mitral position.

SANTINI, Francesco;LUCIANI, GIOVANNI BATTISTA;RESTIVO, Stefano;CASALI, Gianluca;PESSOTTO, Renzo;BERTOLINI, Paolo;ROSSI, Alberto;MAZZUCCO, Alessandro
2001

Abstract

Background. To define the long-term results of 331 standard Hancock porcine bioprostheses implanted in the mitral position between 1973 and 1980. Methods. Of 331 patients (225 male patients, 68%), mean age 49 +/- 10 years (range 14 to 69 years), 88% were in New York Heart Association functional class III or IV and 77% were in atrial fibrillation. Follow-up time extended more than 20 years (mean 13.9 years, range 0.3 to 24.7 years) for a total of 4,601 patient-years. Results. Overall operative mortality was 6.3%. At 5, 10, 15, and 20 years, the actuarial survival rate of patients were 71% +/- 2%, 46% +/- 3%, 30% +/- 3%, and 22% +/- 2%, respectively. Actuarial estimates of freedom from structural valve deterioration were 95% +/- 1%, 67% +/- 3%, 32% +/- 3%, and 14% +/- 3%; from reoperation were 96% +/- 1%, 72% +/- 3%, 36% +/- 4%, and 18% +/- 4%; from thromboembolism were 89% +/- 2%, 82% +/- 3%, 74% +/- 4%, and 51% +/- 2%; and from anticoagulant-related hemorrhage were 98% +/- 1%, 96% +/- 1%, 91% +/- 1%, and 86% +/- 4%. Estimates of freedom from all valve-related mortality at 5, 10, 15, and 20 years were 89% +/- 2%, 76% +/- 3%, 64% +/- 4%, and 48% +/- 4%. Multivariate analysis showed younger age to be a significant risk factor for reoperation. Age at operation did not correlate with structural valve deterioration. Conclusions. The long-term results with the standard Hancock bioprosthesis implanted in the mitral position appear satisfactory, particularly up to 15 years from implantation. Protection from stroke, anticoagulant hemorrhage, and endocarditis was good.
adolescent; adult; aged; bleeding; conference paper; female; follow up; Hancock valve prosthesis; heart atrium fibrillation; human; major clinical study; male; mitral valve prosthesis; mitral valve replacement; multivariate analysis; priority journal; reoperation; risk factor; surgical mortality; survival time; thromboembolism
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S0003497501025243-main.pdf

solo utenti autorizzati

Descrizione: articolo principale
Tipologia: Documento in Post-print
Licenza: Accesso ristretto
Dimensione 166.27 kB
Formato Adobe PDF
166.27 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/232449
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 14
social impact