Stentless porcine valves in the right ventricular outflow tract: improved durability?

John A. Hawkins, Christopher Todd Sower, Linda M. Lambert, Peter C. Kouretas, Phillip T. Burch, Aditya K. Kaza, Michael D. Puchalski, Angela T. Yetman

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: Stentless porcine valves are commonly used for aortic valve replacement in adults, yet their long-term performance in the right ventricular (RV) outflow tract is unknown. We evaluated intermediate-term performance of stentless porcine valves in the RV outflow tract in 150 children and adults over a 10-year period. Methods: We retrospectively reviewed data on all patients undergoing placement of a pulmonary valve or RV-PA conduit with a stentless porcine prosthesis (≥19 mm) from 1998 to 2008. Valvar function was assessed with echocardiography. Freedom from reintervention (explantation or catheter-based intervention) was determined by actuarial methods. Results: A stentless porcine prosthesis was placed in the pulmonary position in 150 patients with a median weight and age of 50.1 kg (range 9.8-127) and 15.8 years (range 1.4-55), respectively. There were three early deaths (2%) and no late deaths. Actuarial freedom from reintervention was 100% at 1 year and 95.5% at 5 years. Peak transvalvar gradient at 1 and 5 years was 13 ± 12 mmHg and 25 ± 11 mmHg, respectively. At last follow-up no patient had severe insufficiency (PI), five patients had moderate PI and the remainder mild or no PI. Conclusions: Stentless porcine valves function well in the pulmonary position over the intermediate-term and are associated with low rates of reintervention in patients requiring a >19 mm valve or valved conduit. Longer-term follow-up and comparison with other alternatives will be necessary to determine if these valves are superior to commonly used allograft or bovine jugular venous valved conduits.

Original languageEnglish (US)
Pages (from-to)600-605
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume35
Issue number4
DOIs
StatePublished - Apr 1 2009

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Swine
Prostheses and Implants
Pulmonary Valve
Lung
Aortic Valve
Allografts
Echocardiography
Neck
Catheters
Weights and Measures

Keywords

  • Conduit
  • Pulmonary valve replacement
  • Stentless porcine valve

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Stentless porcine valves in the right ventricular outflow tract : improved durability? / Hawkins, John A.; Sower, Christopher Todd; Lambert, Linda M.; Kouretas, Peter C.; Burch, Phillip T.; Kaza, Aditya K.; Puchalski, Michael D.; Yetman, Angela T.

In: European Journal of Cardio-thoracic Surgery, Vol. 35, No. 4, 01.04.2009, p. 600-605.

Research output: Contribution to journalArticle

Hawkins, JA, Sower, CT, Lambert, LM, Kouretas, PC, Burch, PT, Kaza, AK, Puchalski, MD & Yetman, AT 2009, 'Stentless porcine valves in the right ventricular outflow tract: improved durability?', European Journal of Cardio-thoracic Surgery, vol. 35, no. 4, pp. 600-605. https://doi.org/10.1016/j.ejcts.2008.12.028
Hawkins, John A. ; Sower, Christopher Todd ; Lambert, Linda M. ; Kouretas, Peter C. ; Burch, Phillip T. ; Kaza, Aditya K. ; Puchalski, Michael D. ; Yetman, Angela T. / Stentless porcine valves in the right ventricular outflow tract : improved durability?. In: European Journal of Cardio-thoracic Surgery. 2009 ; Vol. 35, No. 4. pp. 600-605.
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abstract = "Objective: Stentless porcine valves are commonly used for aortic valve replacement in adults, yet their long-term performance in the right ventricular (RV) outflow tract is unknown. We evaluated intermediate-term performance of stentless porcine valves in the RV outflow tract in 150 children and adults over a 10-year period. Methods: We retrospectively reviewed data on all patients undergoing placement of a pulmonary valve or RV-PA conduit with a stentless porcine prosthesis (≥19 mm) from 1998 to 2008. Valvar function was assessed with echocardiography. Freedom from reintervention (explantation or catheter-based intervention) was determined by actuarial methods. Results: A stentless porcine prosthesis was placed in the pulmonary position in 150 patients with a median weight and age of 50.1 kg (range 9.8-127) and 15.8 years (range 1.4-55), respectively. There were three early deaths (2{\%}) and no late deaths. Actuarial freedom from reintervention was 100{\%} at 1 year and 95.5{\%} at 5 years. Peak transvalvar gradient at 1 and 5 years was 13 ± 12 mmHg and 25 ± 11 mmHg, respectively. At last follow-up no patient had severe insufficiency (PI), five patients had moderate PI and the remainder mild or no PI. Conclusions: Stentless porcine valves function well in the pulmonary position over the intermediate-term and are associated with low rates of reintervention in patients requiring a >19 mm valve or valved conduit. Longer-term follow-up and comparison with other alternatives will be necessary to determine if these valves are superior to commonly used allograft or bovine jugular venous valved conduits.",
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AU - Hawkins, John A.

AU - Sower, Christopher Todd

AU - Lambert, Linda M.

AU - Kouretas, Peter C.

AU - Burch, Phillip T.

AU - Kaza, Aditya K.

AU - Puchalski, Michael D.

AU - Yetman, Angela T.

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N2 - Objective: Stentless porcine valves are commonly used for aortic valve replacement in adults, yet their long-term performance in the right ventricular (RV) outflow tract is unknown. We evaluated intermediate-term performance of stentless porcine valves in the RV outflow tract in 150 children and adults over a 10-year period. Methods: We retrospectively reviewed data on all patients undergoing placement of a pulmonary valve or RV-PA conduit with a stentless porcine prosthesis (≥19 mm) from 1998 to 2008. Valvar function was assessed with echocardiography. Freedom from reintervention (explantation or catheter-based intervention) was determined by actuarial methods. Results: A stentless porcine prosthesis was placed in the pulmonary position in 150 patients with a median weight and age of 50.1 kg (range 9.8-127) and 15.8 years (range 1.4-55), respectively. There were three early deaths (2%) and no late deaths. Actuarial freedom from reintervention was 100% at 1 year and 95.5% at 5 years. Peak transvalvar gradient at 1 and 5 years was 13 ± 12 mmHg and 25 ± 11 mmHg, respectively. At last follow-up no patient had severe insufficiency (PI), five patients had moderate PI and the remainder mild or no PI. Conclusions: Stentless porcine valves function well in the pulmonary position over the intermediate-term and are associated with low rates of reintervention in patients requiring a >19 mm valve or valved conduit. Longer-term follow-up and comparison with other alternatives will be necessary to determine if these valves are superior to commonly used allograft or bovine jugular venous valved conduits.

AB - Objective: Stentless porcine valves are commonly used for aortic valve replacement in adults, yet their long-term performance in the right ventricular (RV) outflow tract is unknown. We evaluated intermediate-term performance of stentless porcine valves in the RV outflow tract in 150 children and adults over a 10-year period. Methods: We retrospectively reviewed data on all patients undergoing placement of a pulmonary valve or RV-PA conduit with a stentless porcine prosthesis (≥19 mm) from 1998 to 2008. Valvar function was assessed with echocardiography. Freedom from reintervention (explantation or catheter-based intervention) was determined by actuarial methods. Results: A stentless porcine prosthesis was placed in the pulmonary position in 150 patients with a median weight and age of 50.1 kg (range 9.8-127) and 15.8 years (range 1.4-55), respectively. There were three early deaths (2%) and no late deaths. Actuarial freedom from reintervention was 100% at 1 year and 95.5% at 5 years. Peak transvalvar gradient at 1 and 5 years was 13 ± 12 mmHg and 25 ± 11 mmHg, respectively. At last follow-up no patient had severe insufficiency (PI), five patients had moderate PI and the remainder mild or no PI. Conclusions: Stentless porcine valves function well in the pulmonary position over the intermediate-term and are associated with low rates of reintervention in patients requiring a >19 mm valve or valved conduit. Longer-term follow-up and comparison with other alternatives will be necessary to determine if these valves are superior to commonly used allograft or bovine jugular venous valved conduits.

KW - Conduit

KW - Pulmonary valve replacement

KW - Stentless porcine valve

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