Malfunction of a Hancock bioprosthesis in the mitral position 24 years after initial implantation.

BACKGROUND AND AIMS OF THE STUDY: Although many types of cardiac bioprosthetic valves are currently available, the major disadvantage of their use is limited durability due to progressive structural valve deterioration. Few such valves function beyond 20 years.

METHODS

A 61-year-old man was admitted urgently to our institute with acute mitral insufficiency, 24 years after undergoing mitral valve replacement with a 25-mm standard Hancock porcine bioprosthesis for mitral stenosis.

RESULTS

Mitral valve reoperation was performed successfully with a mechanical valve. The explanted bioprosthesis showed leaflet perforations and a commissural tear, moderate calcification on the commissures, and pannus overgrowth.

CONCLUSION

The findings in this case suggest that individual patient variables, as well as the design and the construction of the valve are major determining factors in the rate of valve failure.