The Ongoing Debate: Longevity of Biological Valves in Pulmonary Position

Abstract: Background In patients with tetralogy of Fallot (ToF) or ToF-like anatomy, factors possibly impacting the longevity of biological valves in the pulmonary position were investigated. Method Between 1997 and 2017, 79 consecutive hospital survivors with a median age of 8.7 years (range: 0.2–56.1 years; interquartile range [IQR]: 14.8 years) with ToF or ToF-like anatomy underwent surgical implantation of Contegra (n = 34), Hancock (n = 23), Perimount (n = 9), pulmonary homograft (n = 9), and miscellaneous (n = 4) conduits. The median internal graft diameter was 19 mm (range: 11–29 mm; IQR: 8 mm) which refers to a median z-score of 0.6 standard deviation (SD) (range: −1.8 to 4.0 SD; IQR: 2.1 SD). Results The median time of follow-up was 9.4 years (range: 1.1–18.8 years; IQR: 6.0 years). Thirty-nine patients (49%) underwent surgical (n = 32) or interventional (n = 7) pulmonary valve re-replacement. Univariate Cox regression revealed patient age (p = 0.018), body surface area (p = 0.004), internal valve diameter (p = 0.005), and prosthesis z-score (p = 0.018) to impact valve longevity. Multivariate Cox regression analysis, however, did not show any significant effect (likely related to multicollinearity). Subgroup analysis showed that valve-revised patients have a higher average z-score (p = 0.003) and younger average age (p = 0.007). Conclusion A decreased longevity of biological valves in the pulmonary position is related to younger age, lower valve diameter, and higher z-score. Because valve size (diameter and z-score) can be predicted by age, patient age is the crucial parameter influencing graft longevity.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: The Ongoing Debate: Longevity of Biological Valves in Pulmonary Position ; volume:72 ; number:S 03 ; year:2024 ; pages:e1-e6 ; 03 ; The thoracic and cardiovascular surgeon ; 72, Heft S 03 (2024), e1-e6, 03

Contributors, Places and Time

• Contributor: Müller, Marlene ; Biermann, Daniel ; Righa, Miriam Mkanyika ; Carstens, Henning ; Kozlik-Feldmann, Rainer Gerhard ; Hübler, Michael ; Sachweh, Jörg Siegmar

Further information

• DOI: 10.1055/a-2316-8828
• URN: urn:nbn:de:101:1-2407181053083.226006536388
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:48 AM CEST