Document Detail


Porcine heterograft valve replacement in children.
MedLine Citation:
PMID:  7109674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1973 to 1980, 49 patients under 18 years of age survived cardiac valve replacement with Hancock porcine heterografts. Complete follow-up has been obtained on 44 patients (90%) in whom 46 valves were placed. There were 30 boys and 14 girls with an age range of 2 to 18 years (mean 10.0 years). Severe prosthetic valvular dysfunction requiring valve replacement occurred in eight valves in seven patients at 15 to 60 months postoperatively (mean 34.1 months), yielding a calculated replacement rate of 7.1% per patient-year. All eight valves demonstrated severe calcification with stenosis, two valves had significant insufficiency secondary to leaflet disruption, and one valve had a large leaflet perforation. Thirty-one patients with valves in place at 7 to 90 months (mean 38.4 months) are alive, but six have clinical evidence of progressive valvular dysfunction. The mean age at the time of the original Hancock valve placement of the group of patients having undergone replacement of a failed prosthesis together with those with clinical evidence of prosthetic dysfunction was 8.0 years, which is significantly less than that of the remaining group of patients with normally functioning valves (mean 11.2 years, p = 0.043). Actuarial curves demonstrate a predicted replacement-free rate of 87.4% +/- 5.9% at 3 years. 82.3% +/- 7.5% at 4 years, and 58.5% +/- 15.7% at 5 years. On the basis of these data and other reports of early failure in the literature, we have discontinued the routine use of Hancock porcine heterografts for cardiac valve replacement in children in favor of mechanical prostheses.
Authors:
D B Williams; G K Danielson; D C McGoon; F J Puga; D D Mair; W D Edwards
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  84     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1982 Sep 
Date Detail:
Created Date:  1982-10-12     Completed Date:  1982-10-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  446-50     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adolescent
Aortic Valve Stenosis / etiology
Bioprosthesis* / adverse effects,  mortality
Calcinosis / etiology
Child
Child, Preschool
Female
Follow-Up Studies
Heart Valve Prosthesis* / adverse effects,  mortality
Humans
Male
Mitral Valve Stenosis / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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