TY - JOUR

T1 - A stented bovine pericardial prosthesis in the pulmonary position

AU - Pragt, Hanna

AU - Schoots, Mirthe H.

AU - Accord, Ryan E.

AU - Arrigoni, Sara C.

AU - Berger, Rolf M.

AU - Mariani, Massimo A.

AU - Willems, Tineke P.

AU - Ebels, Tjark

AU - Van Melle, Joost P.

PY - 2020/3

Y1 - 2020/3

N2 - Background: Pulmonary valve replacement is very common among patients with congenital heart disease. The Carpentier Edwards Perimount valve (Edwards Lifesciences, Irvine, Calif), which was originally designed for the aortic position is among the most implanted valves. We aim to describe the follow-up of this valve in the pulmonary position.Methods: Patients with a Perimount valve implanted between 2003 and 2013 in the University Medical Center Groningen were followed for the primary end point reintervention, defined as surgical or transcatheter valve replacement. Secondary end point was the occurrence of valve failure, defined as significant valvular regurgitation or stenosis. Explanted valves were histologically examined.Results: Forty-five patients (median age at operation 27.8 years, 55.6% women) had a mean follow-up duration of 5.8 +/- 3.3 years. There were 7 reinterventions (5 surgical and 2 transcatheter). Freedom from reintervention was respectively 95% +/- 4% and 83% +/- 8% at 5- and 10- years of follow-up. Freedom from valve failure was 75% +/- 4% at 2 years, 65% +/- 8% at 5 years of follow-up and 57% +/- 10% at 10 years of follow-up. Morphology evaluation (n = 4) showed stiffened valves in the open position, with extensive fibrous tissue overgrowth on the leaflets and a variable proliferation of myofibroblasts.Conclusions: The Perimount valve has adequate function in the pulmonary valve position at 5 years of follow-up, although after 10 years of follow-up valve failure and reinterventions are common. Explanted valves show retraction and stiffening of the leaflets due to a fibrotic layer on both sides of the leaflet.

AB - Background: Pulmonary valve replacement is very common among patients with congenital heart disease. The Carpentier Edwards Perimount valve (Edwards Lifesciences, Irvine, Calif), which was originally designed for the aortic position is among the most implanted valves. We aim to describe the follow-up of this valve in the pulmonary position.Methods: Patients with a Perimount valve implanted between 2003 and 2013 in the University Medical Center Groningen were followed for the primary end point reintervention, defined as surgical or transcatheter valve replacement. Secondary end point was the occurrence of valve failure, defined as significant valvular regurgitation or stenosis. Explanted valves were histologically examined.Results: Forty-five patients (median age at operation 27.8 years, 55.6% women) had a mean follow-up duration of 5.8 +/- 3.3 years. There were 7 reinterventions (5 surgical and 2 transcatheter). Freedom from reintervention was respectively 95% +/- 4% and 83% +/- 8% at 5- and 10- years of follow-up. Freedom from valve failure was 75% +/- 4% at 2 years, 65% +/- 8% at 5 years of follow-up and 57% +/- 10% at 10 years of follow-up. Morphology evaluation (n = 4) showed stiffened valves in the open position, with extensive fibrous tissue overgrowth on the leaflets and a variable proliferation of myofibroblasts.Conclusions: The Perimount valve has adequate function in the pulmonary valve position at 5 years of follow-up, although after 10 years of follow-up valve failure and reinterventions are common. Explanted valves show retraction and stiffening of the leaflets due to a fibrotic layer on both sides of the leaflet.

KW - pulmonary valve replacement

KW - pericardial heart valves

KW - TERM-FOLLOW-UP

KW - VALVE-REPLACEMENT

KW - BIOPROSTHETIC VALVES

KW - REPAIRED TETRALOGY

KW - MELODY VALVE

KW - FALLOT

KW - RECOMMENDATIONS

KW - PERFORMANCE

KW - DURABILITY

KW - OUTCOMES

U2 - 10.1016/j.jtcvs.2019.05.086

DO - 10.1016/j.jtcvs.2019.05.086

M3 - Article

VL - 159

SP - 1063-+

JO - JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY

JF - JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY

SN - 0022-5223

IS - 3

ER -