The unidirectional valve patch provides no benefits to early and long-term survival in patients with ventricular septal defect and severe pulmonary artery hypertension.
OBJECTIVE
Our aim was to test whether a unidirectional valve patch would provide benefit to early and long-term survival for patients with ventricular septal defect and severe pulmonary artery hypertension.


METHODS
Eight hundred seventy-six cases of ventricular septal defect with severe pulmonary artery hypertension were closed with or without a unidirectional valve patch and were classified as the unidirectional valve patch (UVP) group (n = 195) and nonvalve patch (NVP) group (n = 681), respectively. Propensity scores of inclusion into the UVP group were used to match 138 pairs between the 2 groups. Kaplan-Meier survival curves were constructed to compare early and long-term survival.


RESULTS
For the 138 propensity-matched pairs, there were 7 and 9 early deaths (in-hospital deaths) in the UVP and NVP groups, respectively. The difference in early mortality between the 2 groups did not reach statistical significance (chi(2) = 0.265, P = .6064). With a mean of 9.2 +/- 4.92 years' and 2511 patient-years' follow-up, there were 6 late deaths in the UVP group and 7 late deaths in the NVP group. The difference in actuarial survival at 5, 10, 15, and 18 years between the 2 groups was not significant (log-rank test, chi(2) = 0.565, P = .331). The difference in the late mortality between the groups with or without a patent patch at the time of discharge did not reach statistical significance (chi(2) = 1.140, P = .2856). There was no difference between the 2 groups in the 6-minute walk distance assessed at the last follow-up (525.9 +/- 88.0 meters for the UVP group and 536.5 +/- 95.8 meters for the NVP group, F = 1.550, P = .214).


CONCLUSIONS
A unidirectional valve patch provides no benefits to early and long-term survival when it is used to deal with ventricular septal defect and severe pulmonary artery hypertension.
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China. ganhuili@hotmail.com
Hui-Li
HL
Gan
Jian-Qun
JQ
Zhang
Zhao-Guang
ZG
Zhang
Yi
Y
Luo
Qi-Wen
QW
Zhou
Ping
P
Bo
D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D010496:Pericardium / Q000637:transplantation; D011093:Polyethylene Terephthalates; D057216:Propensity Score; D019919:Prosthesis Implantation; D011651:Pulmonary Artery; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D001672:Biocompatible Materials; D011093:Polyethylene Terephthalates