Fate of Stentless Bioprostheses on Right Side of the Heart

Newly developed stentless bioprostheses have shown good midterm results in the aortic position, but few data are available on their use at the right side of the heart. Four types of stentless bioprosthesis were used for right-side reconstruction of congenital heart anomalies in 50 patients (3 Baxter-Edwards Prima, 27 Medtronic Freestyle, 14 Cryolife Ross, and 6 Medtronic Contegra). Mean age was 9.03 +/- 6.25 years. Serial Doppler echocardiographic studies were performed to evaluate transvalvular pressure gradients. The hospital mortality was 6%. Reoperation was required in 3 patients in the early postoperative period because of left ventricular outflow tract obstruction, endocarditis, or tricuspid insufficiency. Measurements from 34 patients were available for statistical analysis. Clinical follow-up was complete in 43 of the 47 hospital survivors; the mean follow-up period was 16.6 +/- 16 months. Four patients died during follow-up; 93% of the survivors have an unrestricted lifestyle. Although peak transvalvular conduit gradients increased in all types of conduit, no reoperation has yet been performed for conduit stenosis. The newly developed stentless bioprostheses may be a useful alternative for right-side reconstruction of congenital heart anomalies.