Comparative Effects of Pulmonary Valve Replacement (Pvr) Surgery With Bioprosthetic and Mechanical Valves on Early and Late Outcome of Patients After Congenital Heart Surgeries: 10 Years of Experience Publisher



Bigdelian H^{1, 2} ; Mardani D² ; Sedighi M² Show Affiliations
Source: Indian Journal of Thoracic and Cardiovascular Surgery Published:2014

Abstract

Background: Mechanical and bioprosthetic valves are commonly used for pulmonary valve replacement (PVR) in congenital heart surgery, but they may have a different effect on outcomes. Consequently, optimal choice of the valves in pulmonic position remains controversial. Therefore, the aim of this study was to compare early and long-term surgical outcome and survival of patients after PVR with mechanical and bioprosthetic valves.; Methods: Sixty-two patients with congenital heart disease (CHD) who underwent PVR were retrospectively reviewed. The patients were divided into two groups—mechanical valve group (MCV) which included 30 patients and bioprosthetic valve group (BPV) which included 32 patients. Medical records of the patients were collected and analyzed to find differences between the outcomes of groups.; Results: Thromboembolism, bleeding, and sepsis were more common but not statistically significantly higher in MCV group. On the contrary, right ventricular failure, valve dysfunction, and reoperation were non-significantly higher in BPV group. The survival analysis at 10 years did not show any significant difference between the groups. Moreover, compared with causes of mortality in MCV group, which were right ventricular failure, bleeding, pulmonary embolism, and sepsis, the deaths in BPV group were attributed to endocarditis, arrhythmia, and right ventricular failure.; Conclusion: Although bio-prosthetic valves do not require long-time anticoagulants, and mechanical valves have a longer durability, we conclude, based on our results, that neither of mechanical nor bioprosthetic valves have a greater absolute benefits in surgeries for CHD. Hence, we recommend that the decision-making for choice of optimal valve should be related to individual factors and condition of the patient. © 2014, Indian Association of Cardiovascular-Thoracic Surgeons.