Midterm Longevity of Bioprosthetic Pulmonary Valves in Congenital Heart Disease Patients

The durability of bioprosthetic valves in the pulmonary position is not well defined. In the present study, we aimed to examine the durability of bioprosthetic valves in the pulmonary position and the risk factors associated with bioprosthetic pulmonary valve dysfunction or valve failure.
Records of 189 patients who underwent pulmonary valve replacement (PVR) with bioprosthetic valves between 2001 and 2012 were evaluated. The outcomes of PVR were defined as transvalvular leakage, gradient increase or stenosis, hospitalization, and redo PVR. The survival time for the occurrence of the consequences after replacement was depicted as Kaplan–Meier curves.
The most prevalent pathology leading to PVR was the tetralogy of Fallot (81.6%) either due to pulmonary insufficiency or pulmonary stenosis. The most prevalent valve used in our patients was the porcine type. During an average follow-up of 10 years, about 47% of the patients showed different degrees of valvular failure. There was at least moderate transvalvular leakage in the first 5 years in 20% of the patients.
Bioprosthetic pulmonary valves are frequently used in patients with congenital heart disease. Although they avert the need for long-term anticoagulation, they have a degeneration process starting early in the first 5 years. (Iranian Heart Journal 2017; 18(3):21-27)