Thorac Cardiovasc Surg 2012; 60(03): 205-209
DOI: 10.1055/s-0031-1295573
Original Cardiovascular
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Midterm Evaluation of Biological Prosthetic Valves in the Pulmonary Position of Grown-Up Patients

Hunaid A. Vohra
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Robert N. Whistance
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Gedrius Baliulis
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Vilius Janusauskas
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Marrkku Kaarne
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Gruschen R. Veldtman
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Kevin Roman
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Joseph J. Vettukattil
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
James Gnanapragasam
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Anthony P. Salmon
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
,
Marcus P. Haw
1   Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
› Author Affiliations
Further Information

Publication History

27 December 2010

20 June 2011

Publication Date:
12 March 2012 (online)

Abstract

Objectives To examine the midterm clinical outcome of pulmonary valve replacement (PVR) with prosthetic valves.

Methods We reviewed 37 consecutive patients who underwent PVR with biological prosthetic valves between September 1999 and June 2010. The median age was 22.6 years (range: 6 to 70 years; three children). The primary diagnosis was Tetralogy of Fallot in 20 patients (54%). Valve pathology was regurgitation in 27 patients (72.9%). Cardiac surgery had been previously performed in 35 patients (94.5%). The median size of the prosthesis was 25 mm (range: 21 to 31 mm). The median follow-up was 42 months (range: 1.2 to 129 months).

Results There were no early valve-related deaths. Hospital mortality was 2.7% (n = 1) and no patient required early rereplacement of prosthesis. Two patients required permanent pacemaker insertion. During follow-up, there was no late death, reoperation for structural valve degeneration, or valve thrombosis. Only one patient required repeated operation for endocarditis at 37 months follow-up. The actuarial survival at 5 years was 95.1 ± 3.8%. Overall freedom from reoperation after PVR at 5 years was 93.0 ± 8.6%. At last follow-up, 34 patients (91.8%) were NYHA class I versus 20 patients (54%) preoperatively (p < 0.05). In the 35 surviving patients who did not undergo redo-PVR, there was no-mild regurgitation and the peak PV gradient was 20.4 ± 10.2 mm Hg (16.2 ± 9.3 mm Hg preoperatively). Thirty-two patients (91.4%) had good right ventricular function compared with 26 patients (74.2%) preoperatively.

Conclusions PVR with biological prosthetic valves can be performed with good midterm survival, functional status, and haemodynamics.

 
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