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Thorac Cardiovasc Surg. 2012 Apr;60(3):205-9. doi: 10.1055/s-0031-1295573. Epub 2012 Mar 12.

Midterm evaluation of biological prosthetic valves in the pulmonary position of grown-up patients.

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1
Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, United Kingdom.

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.

PMID:
22411751
DOI:
10.1055/s-0031-1295573
[Indexed for MEDLINE]
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