title: Porcine bioprosthetic valve in the pulmonary position: mid-term results in the right ventricular outflow tract reconstruction.
abstract: Pulmonary valve replacement (PVR) for pulmonary valve insufficiency (PVI) currently represents the most frequent reoperation performed for adults with congenital heart disease. A variety of pulmonary valve substitutes have been used, but none has proved to be ideal. This report reviews the authors' experience using a porcine prosthetic valve in the pulmonary position. Between January 2001 and December 2011, 76 patients (mean age, 36 years; range, 18-64 years) underwent PVR for chronic PVI using a porcine bioprosthesis. All the patients had previously undergone surgery: 65 for repair of tetralogy of Fallot and 11 for pulmonary surgical valvotomy. Magnetic resonance imaging (MRI) evaluations before surgery and at the 1-year postoperative follow-up evaluation were compared. Aside from the PVR, 59 patients (59/65, 78 %) received 94 associated cardiac surgical procedures. Two hospital deaths occurred. The mean hospital stay was 13 days (range, 7-48 days). At the 1-year control MRI, pulmonary regurgitation fraction, right ventricular end diastolic volume (RVEDV), and RV/LV EDV had improved significantly. During a mean follow-up period of 52 months (range, 6-132 months), one patient died. All the patients were categorized as New York heart association (NYHA) functional class 1. No episodes of structural valve deterioration, endocarditis, or thromboembolic event were noted. Echocardiography showed trivial or no PVI in all the patients. The porcine bioprosthetic valves demonstrated excellent midterm results in the RV outflow tract reconstruction. The hemodynamic characteristics of this valve are comparable with those of homografts or valved conduits. It is easy to implant and allows for avoiding extensive dissection, especially of the pulmonary arteries.
authors: Department of Cardiac Surgery and GUCH Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se, MI, Italy. alegia@hotmail.com
authors: Alessandro
authors: A
authors: Giamberti
authors: Massimo
authors: M
authors: Chessa
authors: Matteo
authors: M
authors: Reali
authors: Alessandro
authors: A
authors: Varrica
authors: Halkawt
authors: H
authors: Nuri
authors: Giuseppe
authors: G
authors: Isgrò
authors: Alessandro
authors: A
authors: Frigiola
authors: Marco
authors: M
authors: Ranucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011664:Pulmonary Valve / Q000002:abnormalities / Q000601:surgery*; D015607:Stents; D013552:Swine; D013771:Tetralogy of Fallot / Q000601:surgery*; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000151:congenital / Q000601:surgery*