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. 2022 May 14:9:100394.
doi: 10.1016/j.ijcchd.2022.100394. eCollection 2022 Sep.

Surgical pulmonary valve replacement at a tertiary adult congenital heart centre in the current era

Kana Kubota  1   2 , Gerhard-Paul Diller  1   3   4 , Aleksander Kempny  1   4 , Andreas Hoschtitzky  4   5 , Yasushi Imai  1   6 , Masaaki Kawada  7 , Darryl Shore  4   5 , Michael A Gatzoulis  1   4
Affiliations

Surgical pulmonary valve replacement at a tertiary adult congenital heart centre in the current era

Kana Kubota et al. Int J Cardiol Congenit Heart Dis. .

Abstract

Background: Surgical pulmonary valve replacement (PVR) is the standard cardiac operation in adult patients with congenital heart disease (ACHD). We report recent experience at a large tertiary centre and examine the impact of prosthesis type on outcomes.

Methods: All surgical PVRs performed at our tertiary centre between January 2003 and December 2018 were included.

Results: The study population included 490 patients (197 women; mean age 29.9 ± 13 years). The types of valves used were Homograft 179 (37%), Perimount 152 (31%), Mosaic 120 (24%), Hancock 31 (6%), and others 5 (1%). Seven (1.4%) early deaths occurred within 30 days after surgery. The survival rates at 1, 5, 10, and 15 years of follow-up were 98.3%, 97.7%, 96.8%, and 95.4%, respectively, whereas freedom from re-intervention was 99.8%, 96.6%, 90.2%, and 81.0%, respectively. During a mean follow-up of 6.5 ± 4.3 years, 27 (5.5%) patients required re-intervention. The type of valve used in these 27 patients during index operation showed no discernible difference in the probability of re-intervention; however, Mosaic valves required earlier re-intervention compared to Perimount valves.

Conclusion: Our data show no discernible difference in reoperation rates between the different types of prostheses used. On-going surveillance of patients after PVR and further research in developing a life-long prosthesis are clearly warranted.

Keywords: Adult congenital heart disease; Pulmonary valve replacement; Tetralogy of fallot.

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Figures

Fig. 1
Fig. 1
The types of valve prosthesis.
Fig. 2
Fig. 2
Choice of valve type over time.
Fig. 3
Fig. 3
Kaplan-Meier curve of mortality.
Fig. 4
Fig. 4
Kaplan-Meier curve of freedom from re-intervention divided by type of prosthesis.
See this image and copyright information in PMC

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