• Rio Nomoto, Lynn A Sleeper, Michele J Borisuk, Lisa Bergerson, Frank A Pigula, Sitaram Emani, Francis Fynn-Thompson, John E Mayer, Pedro J Del Nido, and Christopher W Baird.
• Tufts Medical School, Boston, Mass; Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
• J. Thorac. Cardiovasc. Surg. 2016 Nov 1; 152 (5): 1333-1342.e3.

ObjectivesThe goal of this single-center series was to assess differences in reintervention by the type of valve used for surgical bioprosthetic pulmonary valve replacement and to identify independent predictors of reintervention.MethodsData were retrospectively collected for 611 patients undergoing pulmonary valve replacement from 1996 to 2014. Kaplan-Meier estimation and Cox proportional hazards regression methodologies were used.ResultsThe median age of patients was 17.8 years (interquartile range, 11.9-27.3). The diagnosis was tetralogy of Fallot in 69% of patients. The median follow-up was 3.0 years (interquartile range, 1.1-5.3). Valve types included Sorin Mitroflow (Milan, Italy), 316 (50%; median age 16.5 years); Carpentier-Edwards (Irvine, Calif) Magna/MagnaEase, 223 (35%; median age, 19.3 years); and Carpentier-Edwards Perimount, 72 (11%; median age, 21.9 years). Reintervention occurred in 6.7% of patients (41/633) and was higher in children than adults (hazard ratio, 4.8). Age-adjusted 5-year reintervention rates were Sorin Mitroflow, 13.4%; Carpentier-Edwards Magna/MagnaEase, 2.1%; and Carpentier-Edwards Perimount, 0%. Reintervention was not associated with gender, valve insertion method, or concurrent procedures. The only independent risk factor for reintervention after controlling for age was valve type (P < .001). The Sorin Mitroflow valve had a shorter time to reintervention than the other 2 valve types (hazard ratios both >7, each P < .001). Differences by valve type did not depend on age (interaction P = .61).ConclusionsBioprosthetic pulmonary valve replacement in patients with congenital heart disease has excellent short-term outcomes, but children have an approximately 5-fold greater risk of reintervention than adults. Independently of age, reintervention rates vary by valve type. These differences may be important in valve selection and follow-up.Copyright © 2016. Published by Elsevier Inc.

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