Abstract
The aim of this study was to investigate the effects of pressure load (pulmonary arterial pressure) on the long-term durability of second-generation xenobioprostheses in the pulmonary position in young adults. Thirteen patients survived pulmonary valve replacement for pulmonary regurgitation using the second-generation aortic porcine bioprosthesis at Sapporo Medical University School of Medicine between 1985 and 2009. The mean age at pulmonary valve replacement was 40.5 years, and the mean prosthetic valve size was 25.3 mm. Two patients developed structural valve deterioration 6 and 9 years, respectively, after pulmonary valve replacement. Both prosthetic valves with structural valve deterioration were subjected to long-term high levels of pressure load. No valve structural failure was observed in the remaining 11 patients who experience low-pressure load during a mean follow-up period of 11.9 years. The freedom from structural valve deterioration at 15 years was 75.8% for the overall population, but 100% for those with low-pressure load. Our findings suggest that the long-term durability of pulmonary-site bioprosthetic valves in young adult patients is promising but that pressure load might be a risk of the limited durability of the valve.
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References
Rowlatt UF, Rimodi HJA, Lev M. The quantitative anatomy of the normal child’s heart. Pediatr Clin North Am. 1963;10:499–588.
Bove EL, Kavey REW, Byrum CJ, Sondheimer HM, Blackman MS, Thomas FD. Improved right ventricular function following late pulmonary valve replacement for residual pulmonary insufficiency or stenosis. J Thorac Cardiovasc Surg. 1985;90:50–5.
Yemetes IM, Wiliams WD, Webb GD, Harrison DA, McLaughlin PR, Trusler GA, Coles JG, Rebeyka IM, Freedom RM. Pulmonary valve replacement late after repair of Tetralogy of Fallot. Ann Thorac Surg. 1997;64:526–30.
Tokunaga S, Masuda M, Shiose A, Tomita Y, Morita S, Tominaga R. Isolated pulmonary valve replacement: analysis of 27 years of experience. J Artif Organs. 2008;11:130–3.
Caldarone CA, McCrindle BW, Van Arsdell GS, Coles JG, Webb G, Freedom RM, Williams WG. Independent factors associated with longevity of prosthetic pulmonary valves and valved conduits. J Thorac Cardiovasc Surg. 2000;120:1022–31.
Williams DB, Danielson GK, McGoon DC, Puga FJ, Mair DD, Edwards WD. Porcine heterograft valve replacement in children. J Thorac Cardiovasc Surg. 1982;84:446–50.
Jamieson WR, Burr LH, Miyagishima RT. Carpentier–Edwards supra-annular aortic porcine bioprosthesis: clinical performance over 20 years. J Thorac Cardiovasc Surg. 2005;130:994–1000.
Soor GS, Leong SW, Butany J, Shapero JL, Williams WG. Pulmonary site bioprostheses, Morphologic findings in 40 cases. Arch Pathol Lab Med. 2009;133:797–802.
Burdon TA, Miller DC, Oyer PE. Durability of porcine valves at fifteen years in a representative North American patient population. J Thorac Cardiovasc Surg. 1992;103:238–52.
Cohen SR, Silver MA, Mcintosh CL, Roberts WC. Comparison of late (62 to 140 months) degenerative changes in simultaneously implanted and explanted porcine (Hancock) bioprostheses in the tricuspid and mitral valve positions in six patients. Am J Cardiol. 1984;53:1599–602.
Finck SJ, Puga FJ, Danielson GK. Pulmonary valve insertion during reoperation for Tetralogy of Fallot. Ann Thorac Surg. 1988;45:610–3.
Ilbawi MN, Idriss FS, Deleon SY, Muster AJ, Berry TE, Paul MH. Long-term results of porcine valve insertion for PR following repair of TOF. Ann Thorac Surg. 1986;41:478–82.
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Takagi, N., Tachibana, K., Miyagi, Y. et al. Influence of pressure load on durability of pulmonic xenobioprostheses in young adults. J Artif Organs 14, 289–293 (2011). https://doi.org/10.1007/s10047-011-0582-8
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DOI: https://doi.org/10.1007/s10047-011-0582-8