title: Long-Term Outcome of Mechanical Pulmonary Valve Replacement in 121 Patients with Congenital Heart Disease.
abstract: BACKGROUND
  A tissue valve is the prosthesis of choice in the majority of children and adults requiring pulmonary valve replacement (PVR). Mechanical valves, on the other hand, are more durable but require anticoagulation therapy and carry the elevated risk of thrombosis. The aim of this study was to investigate the long-term outcomes of mechanical prosthetic valves in a single referral tertiary center. Patients and
  
  
  METHODS
  Recorded data of 121 patients who underwent mechanical PVR between April 2003 and April 2013 at our center were reviewed, retrospectively. Eighty-four patients (69.4%) were male and their mean age was 23.12 ± 7.86 years. Tetralogy of Fallot was the most common diagnosis (n = 109). Complete follow-up was performed for all patients (mean 7.02 ± 1.90 years).
  
  
  RESULTS
  Nobody died and no significant bleeding event was detected during follow-up. Mechanical valve malfunction happened in 10 patients (8.3%) while in 1 of them malfunction happened because of pannus formation and in the remaining 9 because of thrombosis. Just one of the thrombotic events could not be treated with streptokinase and required reoperation. Freedom from reoperation rates were 100, 99, and 98% at 1, 5, and 10 years, respectively; freedom from valve thrombosis event rates were 100, 93, and 91% at 1, 5, and 10 years, respectively; and freedom from bleeding event rates was 98% at 1, 5, and 10 years.
  
  
  CONCLUSIONS
  Mechanical prosthetic valves demonstrated excellent durability and a low risk of valve thrombosis at the pulmonary position when patients are adequately anticoagulated.
authors.affiliation: Department of Cardiovascular Surgery, Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Maziar Gholampour
authors.initials: MG
authors.lastname: Dehaki
authors.affiliation: Department of Cardiovascular Surgery, Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza Alizadeh
authors.initials: AA
authors.lastname: Ghavidel
authors.affiliation: Department of Cardiovascular Surgery, Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Omrani
authors.affiliation: Department of Cardiovascular Surgery, Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Hoda
authors.initials: H
authors.lastname: Javadikasgari
mesh_terms: D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D001705:Bioprosthesis; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007492:Iran; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011664:Pulmonary Valve / Q000002:abnormalities / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D063128:Tertiary Health Care; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000601:surgery; D013927:Thrombosis / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000925:Anticoagulants