초록접수 현황
| 17F-200 | 구연 발표 |
Long-term Durability of Bioprosthetic Valves at Right Ventricular Outflow Tract : Pericardial Valve Versus Porcine Valve
Jae Gun Kwak¹, Chang-Ha lee², Woong-Han Kim¹, Ji Hyun Bang¹, Beatrice Chia-Hui Shih¹, Sungkyu Cho², Jeong Ryul Lee¹, Yong Jin Kim²
¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea., ²Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Gyeonggi-do, Republic of Korea
Purpose : This study sought to compare long-term durability of the pericardial valve (Carpentier-Edward Perimount Magna valve, Edwards Lifesciences, Irvine, CA) and the porcine valve (Hancock II valve (Medtronic, Minneapolis, MN) in the pulmonic position in patients with conotruncal anomalies accompanying with pulmonary stenosis or atresia.
Methods : We retrospectively reviewed the medical records of 258 cases of pulmonary valve implantation or replacement in 248 patients between 2001 and 2009 from two institutions. Carpentier-Edward Perimount valve was implanted in 129 cases (group C), and Hancock II valve was implanted in 129 cases (group H).
Results : The patients' age at pulmonary valve implantation was 14.9±8.7 years. There were no significant differences in pre-operative clinical characteristics in between group C and H. Mean follow-up duration 12.3±5.9 years. During follow-up, 10 patients (4.0%) died. Sixty-four patients underwent re-operation of pulmonary valve replacement. Overall freedom from redo pulmonary valve replacement at 5, 10 and 15 years was 95.7%, 82.4% and 71.6%, respectively. Patients in group C showed significantly higher tendency of reoperation compared with the patients in group H (p=0.001). If the prosthetic valve failure is defined when it showed moderate or severe degree of pulmonary regurgitation or pressure gradient more than 3.5 m/sec of blood velocity through the prosthetic pulmonary valve, freedom from prosthetic valve failure rate showed worse results than reoperation rate. However, porcine valve still showed better outcomes than pericardial valve in valve function (p=0.02).
Conclusion : Porcine valve showed more favorable re-operation free rate and long-term valvular function than pericardial valve in pulmonic position.
Methods : We retrospectively reviewed the medical records of 258 cases of pulmonary valve implantation or replacement in 248 patients between 2001 and 2009 from two institutions. Carpentier-Edward Perimount valve was implanted in 129 cases (group C), and Hancock II valve was implanted in 129 cases (group H).
Results : The patients' age at pulmonary valve implantation was 14.9±8.7 years. There were no significant differences in pre-operative clinical characteristics in between group C and H. Mean follow-up duration 12.3±5.9 years. During follow-up, 10 patients (4.0%) died. Sixty-four patients underwent re-operation of pulmonary valve replacement. Overall freedom from redo pulmonary valve replacement at 5, 10 and 15 years was 95.7%, 82.4% and 71.6%, respectively. Patients in group C showed significantly higher tendency of reoperation compared with the patients in group H (p=0.001). If the prosthetic valve failure is defined when it showed moderate or severe degree of pulmonary regurgitation or pressure gradient more than 3.5 m/sec of blood velocity through the prosthetic pulmonary valve, freedom from prosthetic valve failure rate showed worse results than reoperation rate. However, porcine valve still showed better outcomes than pericardial valve in valve function (p=0.02).
Conclusion : Porcine valve showed more favorable re-operation free rate and long-term valvular function than pericardial valve in pulmonic position.
첨부파일 : 2017 가을학회.pptx
책임저자: Jae Gun Kwak
Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Jae Gun Kwak, E-mail : switch.surgeon@gmail.com