068 * TWENTY-YEAR DURABILITY OF THE AORTIC HANCOCK II BIOPROSTHESIS IN YOUNG PATIENTS: IS IT DURABLE ENOUGH?
Bibliographic record
Abstract
Objectives: The Hancock II bioprosthesis has been reported to have excellent durability in patients ≥60 years of age. This study examined the long-term durability of the Hancock II bioprosthesis in the aortic position, in patients <60 years of age. Methods: From 1982 to 2008, 304 patients aged 59 years or less underwent aortic valve replacement (AVR) with a Hancock II bioprosthesis at two centres. Valve function was longitudinally assessed by echocardiography. Median follow-up was 14.6 years (maximum 27.5 years). Survival and freedom from adverse events were calculated by using the Kaplan-Meier method. Independent predictors of structural valve deterioration (SVD) were assessed with the Cox hazard regression method. Results: Survival and freedom from repeat AVR at 20 years were 57.0 ± 6.1% and 25.4 ± 4.7%, respectively. Over the follow-up duration, 100 patients (32.9%) underwent repeat AVR: 78 for SVD, 11 for endocarditis, 4 for nonstructural valve dysfunction, and 7 for other reasons. The 10- and 20-year freedom from SVD were 90.9 ± 2.1% and 25.2 ± 5.0%, respectively. The independent predictors of SVD were age (HR 0.97/year, 95% CI 0.95-0.99, P < 0.01) and prosthesis-patient mismatch (effective orifice area index ≤0.80 cm2/m2 [HR 1.60 95% CI 1.02-2.49, P = 0.039]). Conclusions: This study showed that the Hancock II bioprosthesis in AVR patients less than 60 years of age is associated with excellent durability during the first decade of follow-up. However, SVD increases dramatically during the second decade and by 20 years, especially in younger patients with prosthesis-patient mismatch. These findings may assist with prosthesis selection between patients and their surgeons.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".