Resultados del recambio valvular pulmonar según el tipo de prótesis implantada

Abstract

Introduction and objectivesPulmonary valve replacement has become the most frequent intervention in adults with congenital heart disease. There is some controversy with respect to the time to intervene and the optimal prosthesis to implant. The objective of this study is to present a review of the performance of three different pulmonary bio-prostheses in our centre between 2003 and 2015. MethodsThe population was divided into three groups according to the prosthesis implanted: Group 1-Medtronic Freestyle (n=14), Group 2-Sorin Soprano (n=24), and Group 3-Carpentier Edwards (n=15). Pre-operative, post-operative, and follow-up clinical and echocardiographic data were recorded. ResultsPulmonary valve replacement resulted in a better post-operative New York Heart Association and left ventricular function improvement in our population. No significant pre-operative differences were seen between groups.In first echocardiogram after surgery, a greater valve gradient was found in Medtronic Freestyle group (P=.053), although it remained stable during follow up. The Sorin Soprano group was associated with a higher valve dysfunction rate (P=.004). There were 20 valve dysfunctions in our series, with 5 of them requiring a valve replacement. There were no early deaths, and only 4 patients died during follow up, with 1 as a cardiac cause. The mean follow-up time was 49.98 months (SD=42.79). ConclusionsPulmonary valve replacement had a low perioperative mortality rate in our series. When comparing between different prosthesis, a higher initial gradient was found in the Medtronic Freestyle group. The Sorin Soprano valve was associated with a higher valve dysfunction rate. However, a longer follow-up is needed to evaluate the performance of the Carpentier Edwards valve.