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Abstract
Experience with Carpentier Edwards® bovine pericardium prosthesis in pulmonary position in patients with congenital heart diseases.Introduction. In recent years the number of patients with complex congenital heart disease previously corrected in infancy who need a pulmonary valve replacement has increased dramatically. The ideal substitute remains a source of dispute. Nowadays, in the unit of cardiovascular surgery of the Hospital Ramon y Cajal in Spain, its being implanting in this position the bovine pericardium Carpentier-Edwards® prosthesis. The aim of the study its short and medium-term assessment. Material and methods. Between January 2004 and May of 2010, 42 patients have been operated for pulmonary valve replacement with pericardium prosthesis. The study was ambispective, being prospective in its last two years. Results. The median age of the patients was 20.96 years (interquartile 10.5 years). The mean number of surgeries prior to the pulmonary valve replacement was 1.9±0.9, being the mean time between the “corrective” surgery and the prosthetic implantation 17.2±7 years. The main indications for this surgery were: right ventricle dysfunction (45%), progressive dilation of the same ventricle (38%), ventricular arrhythmias (14%) and syncopes (3%). Two patients died in the immediate postoperative due to cardiological causes. The mean follow-up time has been 2.1±1.4 years (0.1-6.3). The 94.3 % of the surviving patients are in functional class I, according to the New York Health Association. The peak Doppler transprosthetic gradient determined by echocardiography was 18.5±17 mm Hg. In the echocardiograpic follow-up there have been neither degenerative changes nor any type of structural deterioration of the prosthesis. Conclusions. The bovine pericardium prosthesis in pulmonary position presents excellent results in the short and medium-term. However, it is necessary a longer follow-up to confirm our initial results regarding its durability and long-term haemodynamics.
Keywords: Congenital abnormalities. Heart valve prosthesis. Tetralogy of Fallot. Pulmonary valve. Valve prosthesis implantation.
References
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