Unusual 30-year durability of Hancock II porcine bioprosthesis in tricuspid position.

INTRODUCTION

We describe an unusual durability of a Hancock II porcine bioprosthesis in tricuspid position. Sustainability of bioprostheses is known to be limited especially in young patients.

PRESENTATION OF THE CASE: A 52-year old Caucasian woman with a history of multiple valve interventions. Her clinical presentation of dyspnoea and lower limb oedema led to the diagnosis of severe tricuspid valve stenosis and right heart failure, and was managed by the replacement of the tricuspid bioprosthesis by another bioprosthesis 30-years after the initial implantation.

DISCUSSION: Calcification is the leading cause of bioprosthesis structural deterioration. This immune-induced phenomenon is more pronounced in young patients. Although several patient-related and valve-related factors influence the durability of a xenograft, unknown factors may be of some importance.

CONCLUSION

To our knowledge, this is the first report of a 30-year durability of tricuspid bioprosthesis in a young recipient. In the absence of extensive calcifications, pannus formation covering the whole prosthesis, peculiar hemodynamics and other unknown factors might have contributed to an extended durability in this young patient.