Mid-term results of the Hancock II valve and Carpentier-Edward Perimount valve in the pulmonary portion in congenital heart disease.

BACKGROUND: As the number of cases with artificial pulmonary valve implantation increases for congenital heart disease, the number of young adults with artificial pulmonary valves has also increased.

METHODS: From 2000 to 2007, 146 artificial valves, such as the Carpentier-Edward Perimount, Hancock II, Biocor, homograft and hand-made valves were implanted for pulmonary valve in 132 patients with various forms of congenital heart disease. Among them, the outcomes of the Carpentier-Edward Perimount (n=63) and the Hancock II (n=40) valves were reviewed retrospectively. The mean age at initial implantation was 12.8+/-6.6 years. The overall duration of follow up was 36.0+/-24.2 months.

RESULTS: There was an early death due to right ventricular failure with intractable ventricular arrhythmia and 3 late deaths due to progressive right ventricular failure, dilated cardiomyopathy and infective endocarditis. The overall survival and re-operation free rate was 96.3% and 89.8% respectively. Eight out of 63 Carpentier-Edward patients (12.6%) underwent re-replacement at 49.2+/-25.2 months. The re-operation free rates were 97.7%, 87.7% and 50% at 1, 3 and 5 years respectively. There was no re-operation required for the 40 Hancock II patients over 18.0+/-10.8 months. There was no statistical significance in the re-operation free rates between these 2 valves (p-value=0.51).

CONCLUSIONS: The overall survival rate associated with pulmonary valve bioprosthetic valve implantation was acceptable. However, the re-operation freedom rate was not satisfactory at mid-term for the Carpentier-Edward.