RI Mom
Well-known member
My son's surgeon is suggesting replacing his pulmonary homograft with the Hancock II. Anyone have any experience with this valve?
Hancock II Bioprosthetic anyone?
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The Hancock II is a standard, Medtronics, stented, porcine valve that has been in production for quite a number of years. It has an excellent record for its type of valve. However, it doesn't have any of the advanced features of the Mosaic valve, such as anticalcification treatments or the nondamaging fixation process. That's kind of a question mark for me, as young children can calcify tissue valves fiercely, and that would seem to be an added safety net, to ensure it lasts until he outgrows it.
In short, the Hancock II is a good valve, but is old technology.
However, when it comes to surgery in small children, there are considerations that I am not familiar with. It may be as simple as the Hancock II being the only one that comes in a small enough size. Or there may be something to its configuration that lends it to the specific task. Or the surgeon may be thinking that it has to be replaced in 6-8 years no matter whether it's working perfectly or not, as he'll outgrow it.
The things these surgeons can do to rebuild a child's heart are just fearlessly amazing. But each is so unique in its execution and implications, that it makes it highly unlikely that I could add anything of real value to the surgeon's opinion. Adults are so much easier...
Very best wishes,
In short, the Hancock II is a good valve, but is old technology.
However, when it comes to surgery in small children, there are considerations that I am not familiar with. It may be as simple as the Hancock II being the only one that comes in a small enough size. Or there may be something to its configuration that lends it to the specific task. Or the surgeon may be thinking that it has to be replaced in 6-8 years no matter whether it's working perfectly or not, as he'll outgrow it.
The things these surgeons can do to rebuild a child's heart are just fearlessly amazing. But each is so unique in its execution and implications, that it makes it highly unlikely that I could add anything of real value to the surgeon's opinion. Adults are so much easier...
Very best wishes,
RI Mom
Well-known member
Thanks Bob,
Those 2 valves are now officially on my list of questions for the surgeon.
Those 2 valves are now officially on my list of questions for the surgeon.
RI Mom
Well-known member
Pulmonary Replacement Chosen
Pulmonary Replacement Chosen
I did meet with the surgeon and asked about the other valves available. We went through all of them: contegra, mosaic, synergraft, pericardial valved conduits, etc.... but we came back to the Hancock. The surgeon feels that given the space considerations in my son's small chest that the Hancock with it's more rigid frame will fight for space in the chest and not become compressed which is the concern about Contegra and some of the other products. He specifically said that he stopped using the Mosaic in kids because of some design features which don't allow it to hold up as long in a growing child. Interesting all of the considerations that go into this decision!! Anyway, I walked away feeling confident that this issue has been thought through completely and that we are choosing a good option that hopefully will get us 5-8 years without a trip to the OR.....boy I sure need a long stretch without this stuff!!
Pulmonary Replacement Chosen
I did meet with the surgeon and asked about the other valves available. We went through all of them: contegra, mosaic, synergraft, pericardial valved conduits, etc.... but we came back to the Hancock. The surgeon feels that given the space considerations in my son's small chest that the Hancock with it's more rigid frame will fight for space in the chest and not become compressed which is the concern about Contegra and some of the other products. He specifically said that he stopped using the Mosaic in kids because of some design features which don't allow it to hold up as long in a growing child. Interesting all of the considerations that go into this decision!! Anyway, I walked away feeling confident that this issue has been thought through completely and that we are choosing a good option that hopefully will get us 5-8 years without a trip to the OR.....boy I sure need a long stretch without this stuff!!
Looks like you got some good questions to raise from Bob (tobagotwo), and some reasonable answers from your surgeon. As a former Nova resident and former patient at Inova Fairfax, I just wanted to pass along my very best wishes for your son's pending surgery.
RI Mom
Well-known member
Thanks SuperBob,
I knew there were a few other INOVA patients on this forum. That surgical group has served us well in the past and I feel confident continuing with them.
I knew there were a few other INOVA patients on this forum. That surgical group has served us well in the past and I feel confident continuing with them.
Good to hear that the surgeon had answers - good ones, too - for your questions.
Just curious: do you recall if he had anything to say about the Medtronic Freestyle? It's similar to the Medtronic Hancock series, but has the treatments. Is that one less rigid as well, and thus less useful in the smaller chests of children?
Thank you,
Just curious: do you recall if he had anything to say about the Medtronic Freestyle? It's similar to the Medtronic Hancock series, but has the treatments. Is that one less rigid as well, and thus less useful in the smaller chests of children?
Thank you,
RI Mom
Well-known member
We did not talk about the Freestyle specifically but my guess would be that for one reason or another it may not be the best for this situation. We discussed Contegra, Homograft, Hancock II, SynerGraft, and Mosaic specifically and pericardial valved conduits in general. For my son and his rapid immune response to the Homograft and a smallish chest, the Hancock makes sense. Let's just hope it turns out to be the best choice. All I can do now is to have faith in my surgeon that this will turn out well!!!
Marty
Well-known member
Inova is tops!
Inova is tops!
My doctors in DC referred me to Hopkins, Cleveland Clinic, and Baylor. I had my mitral valve surgery at Inova because I knew the surgeons and the nurses. After some discussion, the chief surgeon opted for a mechanical. I'm very happy with that decision because now ten years later at age 83 I would not be looking for another surgery. I think Inova is the equal if not better than many of the better known centers. Did it bother me going on warfarin? No, two weeks post op my doctors wrote a prescription for a Coaguchek and I've been self dosing ever since. And i've got to know and love vr.com which is always there when you have a problem.
Inova is tops!
My doctors in DC referred me to Hopkins, Cleveland Clinic, and Baylor. I had my mitral valve surgery at Inova because I knew the surgeons and the nurses. After some discussion, the chief surgeon opted for a mechanical. I'm very happy with that decision because now ten years later at age 83 I would not be looking for another surgery. I think Inova is the equal if not better than many of the better known centers. Did it bother me going on warfarin? No, two weeks post op my doctors wrote a prescription for a Coaguchek and I've been self dosing ever since. And i've got to know and love vr.com which is always there when you have a problem.
Just to let you know that I too hope whatever the choice is will turn out well for your little son!
