Does implantation of larger bioprosthetic pulmonary valves in young patients guarantee durability in adults? Durability analysis of stented bioprosthetic valves in the pulmonary position in patients with Tetralogy of Fallot

OBJECTIVES In a previous study, we identified factors affecting the durability of bioprosthetic valves in the pulmonary position following total repair of Tetralogy of Fallot (TOF). In this study, we aimed to identify factors affecting the durability of the bioprosthetic valve with regard to patient...

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Published in:European journal of cardio-thoracic surgery 2016-04, Vol.49 (4), p.1207-1212
Main Authors: Kwak, Jae Gun, Lee, Cheul, Lee, Mina, Lee, Chang-Ha, Jang, So-Ick, Lee, Sang Yun, Park, Su-Jin, Song, Mi Kyoung, Kim, Seong-Ho
Format: Article
Language:English
Subjects:
Adolescent
Adult
Bioprosthesis - adverse effects
Bioprosthesis - statistics & numerical data
Child
Female
Heart Valve Prosthesis - adverse effects
Heart Valve Prosthesis - statistics & numerical data
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - mortality
Heart Valve Prosthesis Implantation - statistics & numerical data
Humans
Male
Pulmonary Valve - pathology
Pulmonary Valve - surgery
Retrospective Studies
ROC Curve
Tetralogy of Fallot - surgery
Young Adult
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Summary:OBJECTIVES In a previous study, we identified factors affecting the durability of bioprosthetic valves in the pulmonary position following total repair of Tetralogy of Fallot (TOF). In this study, we aimed to identify factors affecting the durability of the bioprosthetic valve with regard to patient age and implanted valve size in order to guide valve choice in adolescent patients. METHODS We enrolled and analysed 108 cases of pulmonary valve replacement (PVR) with stented bioprosthetic valves in TOF patients between January 1998 and February 2014. Valvular dysfunction was defined as at least a moderate amount of pulmonary regurgitation or a peak pressure gradient of ≥40 mmHg on the most recent echocardiography. We analysed the effect of patient age and valve size on the durability of the bioprosthetic valve in the pulmonary position. RESULTS There were 2 early deaths; no late deaths were observed. The follow-up duration was 92.8 ± 44.5 months. The mean age at PVR was 19.3 ± 9.1 years. The mean valve size was 24.7 ± 1.8 mm. Whereas patients ≥20 years old showed no valvular dysfunction (i.e. 100% freedom from valvular dysfunction at 10 and 14 years), patients who were adolescents and children (
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezv298