• J. Thorac. Cardiovasc. Surg. · Oct 2017

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    Mechanical valves in the pulmonary position: An international retrospective analysis.

    • Hanna Pragt, Joost P van Melle, Hoda Javadikasgari, Seo Dong Man DM Department of Cardiovascular Surgery, Konkuk University Medical Center, Seoul, Republic of Korea., John M Stulak, Igor Knez, Jürgen Hörer, Christian Muñoz-Guijosa, Mahyar G Dehaki, Hong Ju Shin, Joseph A Dearani, Maziar G Dehaki, Petronella G Pieper, Christine Eulenburg, Laura Dos, and Tjark Ebels.
    • Center for Congenital Heart Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
    • J. Thorac. Cardiovasc. Surg. 2017 Oct 1; 154 (4): 1371-1378.e1.

    ObjectiveLife expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse.MethodsWe retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014. The data originate from medical centers in Barcelona (Spain), Graz (Austria), Groningen (the Netherlands), Munich (Germany), Rochester (United States), Seoul (Republic of Korea), and Tehran (Iran).ResultsMedian follow-up duration was 4.26 years (range, 0-27 years), mean age at implantation was 27.16 ± 12.2 years. Tetralogy of Fallot was the most common primary cardiac diagnosis, with a subgroup of 69.8%. Freedom from valvular thrombosis was 91% (95% confidence interval [CI], 87%-94%) at 5 years and 86% (95% CI, 81%-91%) at 10 years post-PVR. With a success rate up to 88%, thrombolysis was a successful therapy. Freedom from reoperation was 97% (95% CI, 94%-99%) at 5 years post-PVR and 91% (95% CI, 85%-95%) at 10 years.ConclusionsMechanical PVR is associated with a limited risk of valvular thrombosis. Thrombolysis was an effective treatment in the majority.Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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