The Midterm Outcomes of Bioprosthetic Pulmonary Valve Replacement in Children.
Semin Thorac Cardiovasc Surg
; 27(3): 310-8, 2015.
Article
en En
| MEDLINE
| ID: mdl-26708375
ABSTRACT
The purpose of this study was to assess the outcomes of bioprosthetic pulmonary valve replacement (PVR) in children. This is a retrospective review of all bioprosthetic PVR in children (≤ 20-year old) between 1992 and 2013 at a single institution. Most outcomes studied included pulmonary valve reintervention and bioprosthetic valve function. A total of 136 bioprosthetic PVRs were identified for 123 patients. The median age and body weight at the time of operation were 13.2 years and 48.4 kg. There were 1 early death and 3 late deaths during the median follow-up of 7.2 years (0-22.0 years). The actuarial transplant-free survival was 97.6% at 10 years. There were 43 bioprosthesis reinterventions with 29 reoperations and 14 catheter-based interventions. The freedom from bioprosthesis reintervention was 89.6% and 55.0% at 5 and 10 years, respectively. Echocardiographic bioprosthesis dysfunction (≥ moderate bioprosthesis insufficiency, ≥ 50 mmHg peak gradient through bioprosthesis, or bioprosthesis endocarditis with vegetation) was found in 57 bioprostheses. The freedom from bioprosthesis dysfunction was 74.0% and 32.8% at 5 and 10 years, respectively. Results from the Cox proportional hazards models showed that age had significant association with freedom from bioprosthesis reintervention and freedom from bioprosthesis dysfunction (P < 0.001 and P = 0.03), whereas bioprosthesis type had nonsignificant association with freedom from bioprosthesis dysfunction (P = 0.068). Bioprosthetic PVR in children had excellent early outcomes but rapidly deteriorating midterm outcomes. Careful and close follow-up are necessary for children with bioprosthesis in the pulmonary position.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Válvula Pulmonar
/
Insuficiencia de la Válvula Pulmonar
/
Bioprótesis
/
Prótesis Valvulares Cardíacas
/
Predicción
Tipo de estudio:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Semin Thorac Cardiovasc Surg
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2015
Tipo del documento:
Article