Hanna Pragt1, Joost P van Melle1, Hoda Javadikasgari2, Dong Man Seo3, John M Stulak4, Igor Knez5, Jürgen Hörer6, Christian Muñoz-Guijosa7, Mahyar G Dehaki2, Hong Ju Shin3, Joseph A Dearani4, Maziar G Dehaki6, Petronella G Pieper1, Christine Eulenburg8, Laura Dos7, Tjark Ebels9. 1. Center for Congenital Heart Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 2. Department of Cardiovascular Surgery, Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. 3. Department of Cardiovascular Surgery, Konkuk University Medical Center, Seoul, Republic of Korea. 4. Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn. 5. Division of Cardiac Surgery, Medical University of Graz, Graz, Austria. 6. Department of Cardiovascular Surgery and Pediatric Cardiology and Congenital Heart Disease, German Heart Center at the Technical University, Munich, Germany. 7. Integrated Adult Congenital Cardiac Clínic of Vall d'Hebron and Sant Pau University Hospitals, Barcelona, Spain. 8. Medical Statistics and Decision Making, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 9. Center for Congenital Heart Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: T.Ebels@umcg.nl.
Abstract
OBJECTIVE: Life expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse. METHODS: We retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014. The data originate from medical centers in Barcelona (Spain), Graz (Austria), Groningen (the Netherlands), Munich (Germany), Rochester (United States), Seoul (Republic of Korea), and Tehran (Iran). RESULTS: Median follow-up duration was 4.26 years (range, 0-27 years), mean age at implantation was 27.16 ± 12.2 years. Tetralogy of Fallot was the most common primary cardiac diagnosis, with a subgroup of 69.8%. Freedom from valvular thrombosis was 91% (95% confidence interval [CI], 87%-94%) at 5 years and 86% (95% CI, 81%-91%) at 10 years post-PVR. With a success rate up to 88%, thrombolysis was a successful therapy. Freedom from reoperation was 97% (95% CI, 94%-99%) at 5 years post-PVR and 91% (95% CI, 85%-95%) at 10 years. CONCLUSIONS: Mechanical PVR is associated with a limited risk of valvular thrombosis. Thrombolysis was an effective treatment in the majority.
OBJECTIVE: Life expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse. METHODS: We retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014. The data originate from medical centers in Barcelona (Spain), Graz (Austria), Groningen (the Netherlands), Munich (Germany), Rochester (United States), Seoul (Republic of Korea), and Tehran (Iran). RESULTS: Median follow-up duration was 4.26 years (range, 0-27 years), mean age at implantation was 27.16 ± 12.2 years. Tetralogy of Fallot was the most common primary cardiac diagnosis, with a subgroup of 69.8%. Freedom from valvular thrombosis was 91% (95% confidence interval [CI], 87%-94%) at 5 years and 86% (95% CI, 81%-91%) at 10 years post-PVR. With a success rate up to 88%, thrombolysis was a successful therapy. Freedom from reoperation was 97% (95% CI, 94%-99%) at 5 years post-PVR and 91% (95% CI, 85%-95%) at 10 years. CONCLUSIONS: Mechanical PVR is associated with a limited risk of valvular thrombosis. Thrombolysis was an effective treatment in the majority.
Authors: Xu Wang; Wouter Bakhuis; Kevin M Veen; Ad J J C Bogers; Jonathan R G Etnel; Carlijn C E M van Der Ven; Jolien W Roos-Hesselink; Eleni-Rosalina Andrinopoulou; Johanna J M Takkenberg Journal: Front Cardiovasc Med Date: 2022-09-07
Authors: Juan Antonio Meca Aguirrezabalaga; Jacobo Silva Guisasola; Rocío Díaz Méndez; Alain Eliott Escalera Veizaga; Daniel Hernández-Vaquero Panizo Journal: Ann Transl Med Date: 2020-08