Results of Pulmonary Valve Replacement with a Newly Introduced Bioprosthesis in Children and Young Adults with Congenital Heart Disease. Issue 1 (2nd January 2021)

• Record Type: Journal Article
• Authors: Arribas-Leal, Jose M.; Garcia-Vieites, Maria; Jimenez-Aceituna, Antonio; Canovas-Lopez, Sergio; Gutierrez, Francisco; Bautista-Hernandez, Victor
• Is Part Of: Structural heart. Volume 5:Issue 1(2021)
• Page Start: 75
• Page End: 78
• Publication Date: 2021-01-02
• Subjects: Pulmonary valve -- congenital heart disease -- bioprosthesis -- tetralogy of Fallot -- pulmonary valve replacement; Heart -- Diseases -- Periodicals; Congenital heart disease -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular Diseases; Cardiovascular system -- Diseases; Congenital heart disease; Heart -- Diseases; Periodicals; 616.12
• DOI: 10.1080/24748706.2020.1846826
• Languages: English
• ISSNs: 2474-8706

Abstract

ABSTRACT: Background : The durability of bioprostheses in the pulmonary position in patients with congenital heart disease remains suboptimal. The new INSPIRIS Resilia aortic valve is characterized by a pericardial tissue that could improve hemodynamic performance and durability. We report initial experience with this valve in the pulmonary position in children and young patients. Methods : A retrospective study was performed. Demographic, clinical, and echocardiographic data were recorded at hospital stay and through follow-up. Results : Between June 2017 and October 2019, 21 patients (14 males) underwent implantation of an INSPIRIS Resilia bioprosthesis. The most common diagnosis was repaired tetralogy of Fallot ( n = 14). Mean age was 31 ± 16.6 years. Seven patients were children (the youngest 4 years old). One patient with tetralogy of Fallot and preoperative right ventricular failure died after surgery from multiorgan failure. No patient had a permanent pacemaker after surgery or other major complications. Early echocardiograms depicted a mean peak gradient across the valve of 17 ± 7.23 mm Hg, with no paravalvular leaks. At a median follow-up of 20 months (range 1–29 months), all discharged patients were alive without clinical complications. Most recent echocardiograms show good gradients with no paravalvular leaks. Conclusions : In our experience, the INSPIRIS Resilia aortic valve in the pulmonary position provides excellent in-hospital and short-term results in children and young patients with congenital heart disease. Despite showing here one of the longest follow-ups with this prosthesis, longer investigations are required to assess its durability and the feasibility of valve-in-valve procedures in this challenging population. Abreviations : PVR: pulmonary valve replacement; CHD: congenital heart disease; SVD: structural valve deterioration; AVR, aortic valve replacment; ViV, valve-in-valve; RVOT, right ventricular outflow tract