Early- and mid-term results of off-pump pulmonary valve implantation: a single-center experience

Background: This study aims to assess the early- and midterm results of off-pump pulmonary valve implantation (PVI). Methods: Between October 2006 and February 2012, nine patients (5 males, 4 females; mean age 18.4±6.3 years; range 8 to 27 years) underwent off-pump PVI with an injectable stent. Echocardiography revealed severe pulmonary valve regurgitation, progressive right ventricular dilatation and dysfunction in all patients. No residual ventricular septal defect (VSD) was seen. Results: We implanted a 23 mm valve in one patient, a 25 mm valve in two patients, a 27 mm valve in two patients, a 29 mm valve in three patients and a 31 mm valve in one patient. Postoperative echocardiographic examination revealed no regurgitation in seven patients with mild valve regurgitation in two patients. The mean peak systolic gradient was 12.6±3.7 mmHg, while the mean systolic gradient was 8.3±2.4 mmHg. The mean follow-up was 34±17 months (range, 1.5 to 58 months). None of the patients needed reoperation. Conclusion: The advantages of off-pump PVI include the applicability without cardiopulmonary bypass, availability of large-sized valves, the absence of any interventional limitation and the opportunity for fixation into the pulmonary artery to avoid valve migration. No-react nature of the valve also minimizes the degeneration risk of the valve.