Back to Search
Start Over
Long-term follow-up of homograft function after pulmonary valve replacement in patients with tetralogy of Fallot.
- Source :
-
European heart journal [Eur Heart J] 2006 Jun; Vol. 27 (12), pp. 1478-84. Date of Electronic Publication: 2006 May 17. - Publication Year :
- 2006
-
Abstract
- Aims: To analyse the long-term outcomes after pulmonary valve replacement (PVR) in patients with a previous correction for tetralogy of Fallot.<br />Methods and Results: In a retrospective study, 158 adult patients with a diagnosis of tetralogy of Fallot, who had undergone a PVR after initial total correction in childhood, were identified from the CONCOR (CONgenital CORvitia) registry. All patients underwent 175 PVRs between June 1986 and June 2005. To analyse the predictors for homograft dysfunction and adverse events (death, reoperations, balloon angioplasty), Cox-regression analysis was performed. Overall freedom from significant homograft dysfunction was 66% after 5 years and 47% after 10 years. We could not identify predictors for combined homograft dysfunction. Event-free survival was 78% at 10 years and 68% at 15 years after PVR. Both early significant pulmonary regurgitation (PR) (HR 6.8, P = 0.017) and pulmonary stenosis (PS) (HR 4.0, P = 0.037) after surgery were associated with adverse events. When analysing direct post-operative PR or PS, we observed that in patients with severe, pre-operative PR, right ventricular aneurysm/patch resection resulted in a lower post-operative PR (mean difference grade 0.38 +/- 0.14, P = 0.01). Less significant post-operative PS was associated with a higher diameter of the homograft (HR 0.37, P = 0.006).<br />Conclusion: While 47% of the patients in our study were free from homograft dysfunction at 10 years after PVR, event-free survival after PVR remained fairly good (78%). Significant residual lesions directly after surgery influenced event-free survival. A smaller diameter of the pulmonary homograft and severe pre-surgical PR were related to early homograft dysfunction after surgery.
- Subjects :
- Adult
Blood Pressure physiology
Disease-Free Survival
Electrocardiography
Female
Follow-Up Studies
Humans
Male
Pregnancy
Pregnancy Complications, Cardiovascular etiology
Pulmonary Valve Insufficiency complications
Pulmonary Valve Stenosis complications
Reoperation
Retrospective Studies
Transplantation, Homologous
Graft Survival physiology
Heart Valve Prosthesis
Pulmonary Valve
Pulmonary Valve Insufficiency surgery
Pulmonary Valve Stenosis surgery
Tetralogy of Fallot complications
Subjects
Details
- Language :
- English
- ISSN :
- 0195-668X
- Volume :
- 27
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 16707545
- Full Text :
- https://doi.org/10.1093/eurheartj/ehl033