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Poster Display - 157
Mid-term outcomes of mechanical pulmonary valve replacement in patients with congenital heart malformations
Runzhang Liang 1, Jiaxiong Wu 1, Jing Ling 2, Zirui Peng 2, Canxin Wang 1, Naijimuding Abudurexiti 2, Haiyun Yuan 2, Shusheng Wen 2
1 Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
2 Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
Objective To evaluate the mid-term outcomes of mechanical pulmonary valve replacement (PVR) in pediatric patients with congenital heart malformations.
Methods From January 2007 to January 2024, 19 pediatric patients who underwent mechanical PVR at our center were included. The cohort comprised 10 males and 9 females, with a mean age of 19.4 ± 12.9 years, median height of 158.5 cm (IQR: 117.5, 163.8), and mean weight of 40.8 ± 20.4 kg. Comprehensive clinical data spanning preoperative evaluation through postoperative follow-up were analyzed.
Results All patients successfully underwent mechanical PVR, with a mean operative time of 381.3 ± 110.7 min, mean cardiopulmonary bypass time of 208.4 ± 83.18 min, and mean aortic cross-clamp time of 127.5 ± 59.93 min. Postoperative outcomes demonstrated a median mechanical ventilation duration of 27.0 hours (IQR 14.3-123.5), mean ICU stay of 6.0 ± 4.71 days, and median hospitalization period of 11.5 days (IQR 8.0-24.0), with a median follow-up duration of 40.0 months (IQR 9.0-97.5). One pediatric patient died due to heart failure during hospitalization. The remaining pediatric patients had no deaths during follow-up and no moderate or severe pulmonary valve regurgitation occurred. Compared to preoperative levels, postoperative follow-up echocardiography showed that the pulmonary valve transvalvular gradient (P=0.02), tricuspid regurgitant area index (P=0.03), and pulmonary regurgitant area index (P=0.008) all significantly decreased. During follow-up, One pediatric patient developed mechanical valve stenosis 10 years after surgery and underwent pulmonary valve bioprosthesis replacement again. One pediatric patient presented with subvalvular thrombosis, while the remaining pediatric patients had no complications.
Conclusion The mid-term outcomes of mechanical pulmonary valve replacement in pediatric patients are favorable, but strict anticoagulation management is required to reduce the occurrence of complications.