Durability of bioprosthetic valves in the pulmonary position: long-term follow-up of 181 implants in XXXX with congenital heart disease.

@entity1 @entity1757 @entity338 @entity1146 @entity340
OBJECTIVES: Durability of bioprosthetic valves in the pulmonary position is not well defined. We examined the durability of bioprosthetic valves in the pulmonary position and risk factors associated with bioprosthetic @entity338 . METHODS: Between 1993 and 2004, 181 @entity1 underwent @entity338 using bioprostheses. @entity1 who underwent valved conduit or homograft implantation were excluded. Mean age was 14.2    9.8 years and median valve size was 23 mm (range, 19-27 mm). Types of bioprosthesis used were Hancock II (n  =  83), Perimount (n  =  53), Freestyle (n  =  23), Carpentier-Edwards porcine valve (n  =  18), and others (n  =  4). RESULTS: There were 3 early and 7 late deaths. Follow-up completeness was 88.6% and mean follow-up duration was 7.3    2.9 years. Forty-three @entity1 underwent redo @entity338 . Overall freedom from redo @entity338 at 5 and 10 years was 93.9%    1.9% and 51.7%    8.6%, respectively. Overall freedom from both @entity340 at 5 and 10 years was 92.2%    2.1% and 20.2%    6.7%, respectively. In multivariable analysis, younger age at operation, diagnosis of @entity1146 with @entity1757 , and use of stentless valve were identified as risk factors for redo @entity338 . CONCLUSIONS: Durability of bioprosthetic valves in the pulmonary position was suboptimal. Valve function was maintained stable until 5 years after operation. By 10 years, however, about 80% will require reoperation or manifest @entity340 . In our experience, the stentless valve was less durable than stented valves.
