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.
Keywords
pulmonary valve - prosthetic
