Use of the Inspiris valve in the native right ventricular outflow tract is associated with early prosthetic regurgitation.
J Thorac Cardiovasc Surg
; 166(4): 1210-1221.e8, 2023 10.
Article
em En
| MEDLINE
| ID: mdl-37088131
ABSTRACT
OBJECTIVE:
The Inspiris Resilia prosthesis (Edwards Lifesciences) has been increasingly used in the pulmonic position with limited performance data. We sought to investigate its durability as a surgical pulmonary valve replacement (PVR).METHODS:
We retrospectively reviewed patients who underwent PVR or conduit replacement with an Inspiris or non-Inspiris valve/conduit from 2018 to 2022. The primary end point was freedom from a composite of at least moderate pulmonary regurgitation, pulmonary stenosis, or valve/conduit reintervention. Secondary end points were individual components of the composite outcome. To account for baseline differences, propensity matching identified 70 patient pairs.RESULTS:
A total of 227 patients (median age 19.3 years [interquartile range, 11.8-34.4]) underwent PVR or conduit replacement (Inspiris n = 120 [52.9%], non-Inspiris n = 107 [47.1%]). Median follow-up was 26.6 months [interquartile range, 12.4-41.1]. Among matched patients, 2-year freedom from valve failure was lower in the Inspiris group (53.5 ± 9.3% vs 78.5 ± 5.9%, P = .03), as was freedom from at least moderate pulmonary regurgitation (54.2 ± 9.6% vs 86.4 ± 4.9%, P < .01). There was no difference in 2-year freedom from at least moderate pulmonary stenosis (P = .61) or reintervention (P = .92). Inspiris durability was poorer when implanted in the native right ventricular outflow tract compared with as a conduit, with 18-month freedom from valve failure of 59.0 ± 9.5% versus 85.9 ± 9.5% (P = .03).CONCLUSIONS:
Early durability of the Inspiris valve is poor when implanted in the native right ventricular outflow tract; its unique design may be incompatible with the compliant pulmonary root. Modified implantation techniques or alternative prostheses should be considered.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Valva Pulmonar
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Insuficiência da Valva Pulmonar
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Estenose da Valva Pulmonar
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Próteses Valvulares Cardíacas
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Obstrução do Fluxo Ventricular Externo
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Implante de Prótese de Valva Cardíaca
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Ano de publicação:
2023
Tipo de documento:
Article