Early clinical experience with the Hancock porcine xenograft valve prosthesis.

In a 2-year period, 75 Hancock porcine xenograft valves were inserted in 66 patients, 33 male and 33 female. Their average age was 55 years (range 14 to 69 years). The indication for operation was rheumatic heart disease (30 patients), prosthetic valve dysfunction (8 patients), papillary muscle dysfunction (8 patients), degenerative valve disease (13 patients), subacute bacterial endocarditis (3 patients), luetic valve disease (2 patients), congenital heart disease (1 patient), and traumatic valve damage (1 patient). Forty-five valves were placed in the mitral, 28 in the aortic, and 2 in the tricuspid position; 9 patients required double valve replacement. Additional operative procedures included coronary artery vein bypass grafts (12 patients), tricuspid annuloplasty (6 patients), left ventricular aneurysmectomy (4 patients), open mitral valvotomy (3 patients), replacement of ascending aorta (1 patient), and closure of ventricular septal defect (1 patient). There were 2 hospital deaths (3%). Oral anticoagulation was continued for approximately 6 weeks postoperatively, when it was discontinued in all but 8 patients. In the follow-up period-mean 16 months (range 8 to 31 months)-there were 4 late deaths, 2 of which were sudden. There was no documented episode of thromboembolism or valve degeneration. All except 2 patients were clinically improved from NYHA class III or IV preoperatively to class I or II postoperatively. Initial results with Hancock porcine xenograft valves are most satisfactory and compare more than favourably with other commercially available valve substitutes.