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January 15, 2019European Journal of Cardio-Thoracic SurgeryOpen Access

Homografts versus stentless bioprosthetic valves in the pulmonary position: a multicentre propensity-matched comparison in patients younger than 20 years†

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Why the study?

To compare the performance of pulmonary homografts with stentless bioprosthetic valves in the pulmonary position in patients with congenital heart disease younger than 20 years.

Do stentless bioprosthetic valves compared to pulmonary homografts improve freedom from reintervention and structural valve degeneration in patients younger than 20 years with congenital heart disease?

Population

215 CHD patients younger than 20 years across 3 centres in Australia

Comparison

Pulmonary homografts vs Medtronic Freestyle stentless bioprosthetic valves

Design

Multicentre retrospective propensity-matched cohort study

Authors

SMSupreet P MaratheDBDouglas BellKBKim Betts

Discussion

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Overview

Freestyle valves associated with higher late reintervention risk in young CHD patients; leaves open optimal choice in prospective trials.

Structured PICO

Do stentless bioprosthetic valves compared to pulmonary homografts improve freedom from reintervention and structural valve degeneration in patients younger than 20 years with congenital heart disease?

P
Population
215 patients younger than 20 years with congenital heart disease (CHD) requiring valve replacement in the pulmonary position
I
Intervention
Stentless bioprosthetic valves (Medtronic Freestyle) in the pulmonary position
C
Comparator
Pulmonary homografts
O
Outcome
Freedom from reintervention and freedom from structural valve degenerationhard clinical

Stentless bioprosthetic valves are a comparable alternative to pulmonary homografts for up to 10 years in pediatric and young adult patients, but are associated with significantly higher rates of reintervention and structural degeneration thereafter.

Cite This Study

Marathe et al. (2019) studied this question.

synapsesocial.com/papers/6a8bf70f167785443dca9550https://doi.org/10.1093/ejcts/ezz021
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Medium-term outcomes after pulmonary valve replacement with the Freestyle valve for congenital heart disease: a case series2016 · 17 citations
  2. 2Evaluation of 188 consecutive homografts implanted in pulmonary position after 20 years☆☆☆2007 · 110 citations
  3. 3Comparison between homografts and Freestyle(R) bioprosthesis for right ventricular outflow tract replacement in Ross procedures2012 · 35 citations
  4. 4Stentless xenografts as an alternative to pulmonary homografts in the Ross operation†2013 · 21 citations
  5. 5Factors Affecting Longevity of Homograft Valves Used in Right Ventricular Outflow Tract Reconstruction for Congenital Heart Disease2000 · 249 citations