Abstract 20869: Long-Term Durability of Bioprosthetic Valves at Right Ventricular Outflow Tract

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Objective: This study sought to compare long-term durability of the pericardial valve (Carpentier-Edward Perimount Magna valve, Edwards Lifesciences, Irvine, CA) and the porcine valve (Hancock II valve, Medtronic, Minneapolis, MN) in the pulmonic position in patients with conotruncal anomalies accompanying with pulmonary atresia or stenosis.

Methods: We retrospectively reviewed the medical records of 258 cases of pulmonary valve implantation in 248 patients between 2001 and 2009 from 2 institutions. Carpentier-Edward Perimount valve was implanted in 129 cases (Group C), and Hancock II valve was implanted in 129 cases (Group H). Most common diagnoses were tetralogy of Fallot (n=179, 69.4%) and pulmonary atresia with ventricular septal defect (n=38, 14.7%).

Results: The patients’ age at pulmonary valve implantation was 14.9 ± 8.7 years. There were no significant differences in pre-operative clinical characteristics in between group C and H. Median follow-up duration of 12.7 years (range: 0.6~20.3 years). We have 10 mortalities (4.0%). Overall freedom from redo pulmonary valve replacement at 5, 10 and 15 years was 95.7%, 82.4% and 71.6%, respectively. Patients in group C showed significantly higher reoperation rate than the patients in group H (P=0.001, figure 1-A). If the prosthetic valve failure is defined as pulmonary regurgitation ≥ moderate, or pulmonary stenosis ≥ 3.5 m/sec of velocity through the prosthetic valve on echocardiography, as well as reoperation, freedom from prosthetic valve failure rate showed worse results in both groups. However, porcine valve still showed better outcomes than pericardial valve in valve function (p=0.02,figure 1-B).

Conclusions: Hancock II showed better re-operation free rate and valve function than the Carpentier-Edward Perimount Magna valve in the pulmonic position in patients with various congenital cardiac anomalies accompanying with right ventricular outflow tract stenosis or atresia.

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