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Ann Thorac Surg 1986;41:478-482
© 1986 The Society of Thoracic Surgeons

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Articles

Long-Term Results of Porcine Valve Insertion for Pulmonary Regurgitation Following Repair of Tetralogy of Fallot

Divisions of Cardiovascular-Thoracic Surgery and Cardiology, The Children's Memorial Hospital, and the Departments of Surgery and Pediatrics, Northwestern University Medical School, Chicago, IL

Accepted for publication July 18, 1985.

^* Address reprint requests to Dr. Ilbawi, Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614

Between January 1975 and January 1985, 49 patients, aged 2 to 20 years, underwent porcine valve insertion for control of pulmonary regurgitation following repair of tetralogy of Fallot. In 9 patients the valve was placed at the time of the repair; in the remaining 40, valve insertion was performed 2 to 5 years postoperatively. The primary indications for valve implantation included progressive cardiomegaly and evidence of right ventricular (RV) dilatation or dysfunction. Operative technique emphasized ample enlargement of the RV outflow tract and main pulmonary artery to allow for insertion of a large valve and prevention of turbulence or stenosis. There was 1 hospital death (2%). Follow-up is available on remaining patients 1 to 10 years postoperatively. Considerable prosthetic valvar stenosis or regurgitation occurred in 7 patients (14%) 3 to 8 years following insertion, including one after subacute bacterial endocarditis. The complication-free actuarial life was 82%, and the functional actuarial life was 84% at 10 years for the prosthesis. The data suggest that the porcine valve has a good long-term durability when inserted in the pulmonary position in pediatric patients.

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