Performance of stented biological valves for right ventricular outflow tract reconstruction

Buchholz C, Mayr A, Purbojo A, Glöckler M, Toka O, Cesnjevar R, Rueffer A (2016)


Publication Type: Journal article

Publication year: 2016

Journal

Book Volume: 23

Pages Range: 933-939

Journal Issue: 6

DOI: 10.1093/icvts/ivw264

Abstract

This retrospective single-centre review presents mid- and long-term results of stented biological valves (SBVs) in the pulmonary position.Fifty-two SBVs (17 Carpentier-Edwards Supraannular; 13 Carpentier-Edwards Perimount; 12 St. Jude Medical Trifecta; 4 Sorin Mitroflow; 4 Sorin Soprano; 2 Sorin More) were implanted between 2000 and 2015. The median valve size, patient age and weight were 23 mm (range 19-27), 22.8 years (range 5-77) and 62.0 kg (range 14-110), respectively. The main cardiac diagnosis was tetralogy of Fallot in 26 patients (50%). Forty-four patients (85%) had previous cardiac surgery; 12 patients (23%) had previous conduit or biological valve replacement. Valve degeneration was defined as a valvular peak pressure gradient >50 mmHg or pulmonary valve regurgitation more than moderate.The mean follow-up was 7.9 ± 5.5 years. Two patients died after 5.8 and 6.1 years of causes not related to SBVs. Eleven SBVs (21%) had to be replaced surgically (n = 6) or interventionally (n = 5) after 9.0 ± 4.1 years due to valve degeneration (n = 8), endocarditis (n = 2) or right ventricular dysfunction (n = 1). The rates of freedom from valve replacement were 100%, 92% [95% confidence interval (CI) 79-97], 81% (CI 64-91) and 60% (CI 40-78) after 1, 5, 10 and 15 years, respectively. Successful interventional valve-in-valve implantation resulted in 100% freedom from surgical valve replacement in all patients older than 19.1 years. Multivariate analysis identified patient age <19.1 years (P = 0.007) as a risk factor for earlier valve degeneration.SBVs in the pulmonary position showed encouraging long-term results in mature patients. The design of SBVs enables interventional valve implantation, postponing the need for reoperation.

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How to cite

APA:

Buchholz, C., Mayr, A., Purbojo, A., Glöckler, M., Toka, O., Cesnjevar, R., & Rueffer, A. (2016). Performance of stented biological valves for right ventricular outflow tract reconstruction. Interactive Cardiovascular and Thoracic Surgery, 23(6), 933-939. https://doi.org/10.1093/icvts/ivw264

MLA:

Buchholz, Christian, et al. "Performance of stented biological valves for right ventricular outflow tract reconstruction." Interactive Cardiovascular and Thoracic Surgery 23.6 (2016): 933-939.

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