Performance of bovine pericardial valves in the pulmonary position.
BACKGROUND
The purpose of this study is to determine the outcome and performance of bovine pericardial valves in the pulmonary position.


METHODS
This is a retrospective review of all patients with congenital heart disease who had pulmonary valve replacement using a bovine pericardial valve from 2002 to 2009 at a single institution.


RESULTS
There were 73 consecutive patients, with a median age of 17.3 years (range, 2.1 to 64.4). Their diagnosis was tetralogy of Fallot (n = 47), pulmonary stenosis (n = 11), or other (n = 15). Sixty-nine patients had 91 previous surgical procedures. The mean time from last surgery was 19.9 ± 11.6 years. Forty-three patients had concomitant surgical procedures. There were no perioperative deaths. Clinical follow-up was available in 68 patients (93%). There were no late deaths, and all patients were in New York Heart Association functional class I during a median follow-up period of 2.6 years (range, 0.2 to 8.0). One patient had endocarditis necessitating valve removal 2 years after surgery. Freedom from pulmonary valve reoperation was 100%, 97.7%, and 97.7% at 1, 3, and 5 years, respectively (95% confidence interval: 93.2% to 100%). Mean pulmonary valve gradient at follow-up was 19 ± 14 mm Hg. Degree of pulmonary insufficiency was less than moderate in 62 patients, moderate in 4, and more than moderate in 2. Freedom from moderate-severe or severe pulmonary insufficiency was 97.7%, 89.1%, and 89.1% at 1, 3, and 5 years, respectively (5-year 95% confidence interval: 77.0% to 100%).


CONCLUSIONS
Pulmonary valve replacement using a bovine pericardial valve can be accomplished with low perioperative morbidity and favorable midterm outcomes. Further follow-up is necessary to evaluate the long-term performance of bovine pericardial valves in the pulmonary position.
Shinkawa
Takeshi
T
Division of Pediatric Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California, USA.
Anagnostopoulos
Petros V
PV
Johnson
Natalie C
NC
Watanabe
Naruhito
N
Sapru
Anil
A
Azakie
Anthony
A
D000293:Adolescent; D000328:Adult; D000818:Animals; D001705:Bioprosthesis; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011664:Pulmonary Valve / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult