HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Andrew C. Fiore Mark Rodefeld Mark Turrentine Palaniswamy Vijay John W. Brown Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fiore, A. C. Articles by Brown, J. W. Search for Related Content PubMed PubMed Citation Articles by Fiore, A. C. Articles by Brown, J. W. Related Collections Congenital - acyanotic

---

Original Articles: Pediatric Cardiac

Pulmonary Valve Replacement: A Comparison of Three Biological Valves

^a Division of Cardiothoracic Surgery, St. Louis University School of Medicine, Cardinal Glennon Children's Hospital, St. Louis, Missouri
^b Indiana University School of Medicine, James Whitcomb Riley Children's Hospital, Indianapolis, Indiana

Accepted for publication November 21, 2007.

^_* Address correspondence to Dr Fiore, St. Louis University School of Medicine, Cardinal Glennon Children's Hospital, 1465 S Grand Blvd, St. Louis, MO 63104 (Email: fiorem2{at}slu.edu).

Presented at the Fifty-third Annual Meeting of the Southern Thoracic Surgical Association, Tucson, AZ, Nov 8–11, 2006.

Background: We retrospectively reviewed the performance of the mosaic porcine, bovine pericardial, and homograft prostheses for pulmonary valve replacement to correct chronic pulmonary insufficiency.

Methods: From January 1995 to August 2006, 82 patients (mean age, 22.7 years) underwent valve replacement with porcine (49 patients), bovine pericardial (18 patients), or pulmonary homograft (15 patients) prosthesis at a mean of 15.3 years after initial outflow tract reconstruction. Excluded were patients with extracardiac conduits, monocusp valves, or the Ross procedure. The groups were similar with respect to age, body surface area, degree of regurgitation, right ventricular dimension, right ventricular to pulmonary artery gradient, and valve size. Follow-up was longer in the homograft cohort (porcine, 20 ± 27 months; pericardial, 42 ± 21; homograft, 49 ± 40; p < 0.01).

Results: All three prostheses significantly reduce chronic pulmonary regurgitation, but late insufficiency was higher with homografts. Right ventricular dimension was significantly reduced in the stented but not the allograft cohorts. Late valve dysfunction was highest with homografts (54%), followed by porcine (19%) and pericardial valves (5.5%; p < 0.05. Functional class and mild to moderate tricuspid insufficiency significantly improved with pulmonary valve replacement. Early and late mortality was 3.6% and 1.2%, respectively.

Conclusions: All three prostheses performed similarly for 3 years. Pulmonary regurgitation developed more frequently in homografts albeit at a longer duration of follow-up.

This article has been cited by other articles:

				V. Dayan, F. Gutierrez, L. Cura, G. Soca, and A. Lorenzo Two Cases of Pulmonary Homograft Replacement for Isolated Pulmonary Valve Endocarditis. Ann. Thorac. Surg., June 1, 2009; 87(6): 1954 - 1956. [Abstract] [Full Text] [PDF]