DURABILITY OF HANCOCK PORCINE BIOPROSTHESIS IN THE TRICUSPID POSITION:10-TO 16-YEAR EXPERIENCE

Abstract

From February 1975 to August 1981, 19 patients had tricuspid valve replacement, either isolated (6) or combined with replacement of other valves (13) by means of a standard, glutaral-dehyde-preserved Hancock porcine bioprosthesis. Follow-up ranged from 0.2 to 16.2 years (mean, 9.0±4.6 years) and was completed in 100%. Primary tissue failure (PTF) of the tricuspid Hancock valve was noticed in one patient of 9 years-old boy 40 months after implantation. Actuarial freedom from PTF at 10 yars was 94±6%. Five couples of mitral-tricuspid Hancock valves explanted simultaneously from the same patient after 97 to 166 months (mean, 136±25 months). Gross examination showed no significant changes in the explants from the tricuspid position but degenerative changes with dysfunction in those from the mitral and aortic positions (p<0.03). There were 4 tricuspid prosthesis-related events except prophylactic removal; valve thrombosis, prosthetic valve endocarditis, PTF, and periprosthetic leak. Actuarial freedom from these events at 10 years was 74±10%. Selection of tissue valve in the tricuspid position is acceptable because low incidence of prosthesis-related complications and good durability for more than 120 months in not only adults but children.