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The Journal of Thoracic and Cardiovascular Surgery, Vol 102, 187-194, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Patterns of failure in Hancock pericardial bioprostheses

VM Walley, FD Rubens, M Campagna, AL Pipe and WJ Keon
Department of Pathology, University of Ottawa, Ontario, Canada.

A series of Hancock pericardial valve bioprostheses was reviewed for cases of primary valve failure. Thirteen mitral and 10 aortic valve explants were recovered from 21 adult patients. Mitral valves had been in place for a mean of 56.4 months, and aortic valves for 53.8 months. All valves failed with cusp tears from stents (with a mean of 1.7 for mitral valves and 2.6 for aortic valves) in a predictable pattern, suggesting that wear and stress at cusp stitch sites are important in their pathogenesis. The topography of these tears is illustrated as are the less common associates of primary failure, such as calcification, fibrosis, and thrombosis. Similarities and differences of this valve's failure compared with that of the Ionescu-Shiley pericardial valve are discussed.

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