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.
Gan
Hui-Li
HL
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
Zhang
Jian-Qun
JQ
Zhang
Zhao-Guang
ZG
Luo
Yi
Y
Zhou
Qi-Wen
QW
Bo
Ping
P
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