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

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22 Scopus citations

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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Keywords

  • Conduit
  • Pulmonary valve replacement
  • Stentless porcine valve

ASJC Scopus subject areas

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

Cite this

Hawkins, J. A., Sower, C. T., Lambert, L. M., Kouretas, P. C., Burch, P. T., Kaza, A. K., Puchalski, M. D., & Yetman, A. T. (2009). Stentless porcine valves in the right ventricular outflow tract: improved durability? European Journal of Cardio-thoracic Surgery, 35(4), 600-605. https://doi.org/10.1016/j.ejcts.2008.12.028