Porcine heterograft valve replacement in children

Donald Williams, G. K. Danielson, D. C. McGoon, F. J. Puga, D. D. Mair, W. D. Edwards

Research output: Contribution to journalArticle

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Abstract

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 prosthesis 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.

Original languageEnglish
Pages (from-to)446-450
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume84
Issue number3
StatePublished - Dec 1 1982
Externally publishedYes

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Heterografts
Swine
Prostheses and Implants
Heart Valves
Pathologic Constriction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Williams, D., Danielson, G. K., McGoon, D. C., Puga, F. J., Mair, D. D., & Edwards, W. D. (1982). Porcine heterograft valve replacement in children. Journal of Thoracic and Cardiovascular Surgery, 84(3), 446-450.

Porcine heterograft valve replacement in children. / Williams, Donald; Danielson, G. K.; McGoon, D. C.; Puga, F. J.; Mair, D. D.; Edwards, W. D.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 84, No. 3, 01.12.1982, p. 446-450.

Research output: Contribution to journalArticle

Williams, D, Danielson, GK, McGoon, DC, Puga, FJ, Mair, DD & Edwards, WD 1982, 'Porcine heterograft valve replacement in children', Journal of Thoracic and Cardiovascular Surgery, vol. 84, no. 3, pp. 446-450.
Williams D, Danielson GK, McGoon DC, Puga FJ, Mair DD, Edwards WD. Porcine heterograft valve replacement in children. Journal of Thoracic and Cardiovascular Surgery. 1982 Dec 1;84(3):446-450.
Williams, Donald ; Danielson, G. K. ; McGoon, D. C. ; Puga, F. J. ; Mair, D. D. ; Edwards, W. D. / Porcine heterograft valve replacement in children. In: Journal of Thoracic and Cardiovascular Surgery. 1982 ; Vol. 84, No. 3. pp. 446-450.
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