Abstract 10172: Stentless Porcine Pulmonary Valves Demonstrate Superior Ten-Year Durability in Adults
Introduction: There are multiple bioprosthetic valve options for pulmonary valve replacement (PVR) or reconstruction of the right ventricular outflow tract (RVOT). There is currently little long-term data on the outcomes of these valves. This study was undertaken to evaluate the long-term durability and efficacy of these valves in adults.
Hypothesis: Bioprosthetic pulmonary valves will have variable ten-year durability depending on valve type.
Methods: A retrospective review was conducted of all adult patients (≥ 21 years) receiving a pulmonary valve between 1990 and 2009 at our institutions. Patients were stratified according to valve type: standard allograft (AL), Synergraft (SG), and stentless porcine (P). The primary outcome for study was reintervention, defined as either balloon valvuloplasty or valve explant. Standard statistical analysis was applied to compare the three patient groups.
Results: One hundred eighty patients had PVR or RVOT reconstruction. AL were used in 104 (57.7%), SG in 22 (12.2%), and P in 54 (30.0%). Patients in the P group were younger (31.9 ± 9.5 years) compared with 37.4 ± 11.5 years in the AL group and 37.2 ± 10.5 years in the SG group (p = 0.007). Ten-year freedom from reintervention was 86.3% in the AL group, 74.4% in the SG group, and 96.8% in the P group (p = 0.103). Freedom from balloon valvuloplasty at ten years was 98.9% in the AL group, 81.3 % in the SG group, and 96.8% in the P group (p = 0.006). Ten-year freedom from valve explant was 87.2% in the AL group, 95.0% in the SG group, and 100.0% in the P group (p = 0.087).
Conclusions: All forms of stentless tissue valves had good freedom from reintervention at ten years. The stentless porcine group had superior freedom from all reintervention and explants compared to the allograft groups. This study demonstrates the durability and utility of stentless porcine bioprostheses for RVOT reconstruction in adult patients.
- © 2011 by American Heart Association, Inc.