Philip Oyer

Publication Details

  • CLINICAL DURABILITY OF THE HANCOCK PORCINE BIOPROSTHETIC VALVE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY Oyer, P. E., Miller, D. C., Stinson, E. B., Reitz, B. A., MORENOCABRAL, R. J., Shumway, N. E. 1980; 80 (6): 824-833

    Abstract:

    The principal feature of the Hancock xenograft bioprosthesis which remains to be completely defined is long-term durability. This report provides extended data regarding valve durability derived from a data base of 1,407 patients (707 aortic [AVR] and 700 mitral [MVR] replacements) who received Hancock bioprostheses between 1971 and 1979; cumulative duration of follow-up was 1,732 patient-years for AVR and 1,843 for MVR patients, with a maximum follow-up duration of 8.4 years. One hundred seventy-nine patients were followed for more than 5 years and 67 for more than 6 years. Valve failure was defined on the basis of one or more of the following criteria: (1) postoperative development of a new regurgitant murmur, (2) thrombotic valvular occlusion, (3) infective endocarditis resulting in reoperation or death, and (4) hemodynamic valvular dysfunction confirmed by catheterization and resulting in reoperation or death. Twenty-one such failures occurred among all AVR patients and 23 among all MVR patients. The actuarial probability of freedom from valve failure (all causes) was 95.4% +/- 1.2% (+/- SEM) for adult AVR patients 5 years postoperatively and 90.9% +/- 2.6% for adult MVR patients 6 years postoperatively. The probability of freedom from primary tissue failure in adults was 99% +/- 1% in AVR patients at 5 years and 94.3% +/- 2.4% in MVR patients at 6 years. The linearized incidence of primary tissue failure in children (< 15 years old) was 9.8% per patient-year (combined AVR and MVR patients), compared to 0.2% per patient-year among all adult patients in the analysis. The combined actuarial incidence of primary tissue failure among adults with AVR and MVR was 98.6% +/- 0.7% at 5 years and 94.2% +/- 2.3% at 6 years; thus there appears to be a slight acceleration in the rate of valve tissue failure between 5 and 6 years after operation. The incidence of failure, however, remains acceptably low through 6 years of follow-up, and continued clinical use of the xenograft bioprosthesis seems warranted.

    View details for Web of Science ID A1980KT96500002

    View details for PubMedID 7431981

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