Why the study?
Does the Hancock porcine xenograft valve improve clinical and hemodynamic outcomes compared to the Angell-Shiley valve in patients undergoing isolated mitral valve replacement?
Does the Hancock porcine xenograft valve improve clinical and hemodynamic outcomes compared to the Angell-Shiley valve in patients undergoing isolated mitral valve replacement?
The Hancock porcine xenograft valve provided superior intermediate-term clinical and hemodynamic outcomes compared to the Angell-Shiley valve for isolated mitral valve replacement, though both valves showed hemodynamic deterioration during exercise.
Hancock valve associated with better mitral replacement outcomes; hypothesis-generating and should not yet change practice without randomized confirmation.
KAGAWA, Y., TABAYASHI, K., SUZUKI, Y., ITO, T., SATO, N. and HORIUCHI, T. Intermediate Term Results of Isolated Mitral Valve Replacement with Glutaraldehyde-Preserved Porcine Xenograft Valve: Clinical and Hemodynamic Comparison between Hancock Valve and Angell-Shiley Valve. Tohoku J. exp. Med., 1986, 150 (1), 37-50-Clinical and hemodynamic assessments were carried out for 30 cases, who underwent isolated mitral valve replacement with glutaraldehyde-preserved porcine xenograft valve. The cases were divided into two groups, according to the types of prostheses. Group H comprised 23 cases with Hancock 342 valve and group AS, 7 cases with Angell-Shiley valve. Mean (S.D.) follow-up periods were 4.0±0.7 in group H and 4.6±0.6 years in group AS. Incidence of valvular malfunction was 3.3 in group H and 9.3% per patient-year in group AS. Cumulative survival and event-free rates were calculated by actuarial method, which revealed 91 and 83% in group H and 70 and 71% in group AS at 6 years after operation. Hemodynamic assessments were carried out in 20 cases, in which complete data at rest and during exercise were obtained. Valvular function deteriorated during exercise in both groups. Parameters showing valvular function in group AS were worse than those in group H. It is concluded from this study that (1) intermediate late results are satisfactory in group H, (2) incidence of valvular malfunction is high in children and in group AS, (3) thromboembolisms are seen even in cases with recourse to anticoagulant, (4) xenograft valves are stenotic especially in high flow state and (5) valvular function of AS valve is inferior to H valve.
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Kagawa et al. (1986) studied this question.
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