The fate of Hancock II porcine valve recipients 25 years after implant.

Objective: The Hancock II (HII) is a second-generation porcine bioprosthesis introduced into clinical use in 1982. This study aimed to evaluate very long-term outcomes for the HII valve in a large patient population. Methods: Between May 1983 and November 1993, 517 consecutive patients (pts) (309 male, mean age: 64 ± 9 years) underwent valve replacement (VR) surgery with HII, with 302 (58.4%) in the aortic VR (AVR) and 215 (41.6%) in the mitral VR (MVR) position, respectively. At implant, 106 pts (20.5%) were <60 years of age (G1), while 411 (79.5%) were ≥60 years of age (G2). The 25-year follow-up was complete for all pts at a median of 12 years (range: 0–25). Results: Long-term death occurred in 208 AVR and in 165 MVR pts. Survival at 15 and 20 years was 39.5% and 23.3% in AVR pts and 39.0% and 15.8% in MVR pts. At 25 years the survival of MVR pts was 13.7% (four pts at risk). Late freedom from re-operation was 85.5% and 79.3% at 15 and 20 years in the AVR pts and 73.3% and 52.8% in the MVR pts, respectively. In the AVR population, 20-year freedom from re-operation was 52.2% in G1 pts and 86.8% in G2 pts (p < 0.0001), while in the MVR population it was 41.4% in G1 pts and 61.9% in G2 pts (p = 0.201), respectively. Conclusions: These results confirm the excellent long-term performance of the HII bioprosthesis.