RT Journal Article
SR Electronic
T1 Infective endocarditis of a transcatheter pulmonary valve in comparison with surgical implants
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 788
OP 793
DO 10.1136/heartjnl-2014-306761
VO 101
IS 10
A1 Van Dijck, Ine
A1 Budts, Werner
A1 Cools, Bjorn
A1 Eyskens, Benedicte
A1 Boshoff, Derize E
A1 Heying, Ruth
A1 Frerich, Stefan
A1 Vanagt, Ward Y
A1 Troost, Els
A1 Gewillig, Marc
YR 2015
UL http://heart.bmj.com/content/101/10/788.abstract
AB Background Melody valved stents (Medtronic Inc, Minneapolis, Minnesota, USA) have become a very competitive therapeutic option for pulmonary valve replacement in patients with congenital heart disease. After adequate prestenting of the right ventricular outflow tract (RVOT) Melody valved stents have a good medium term functional result but are exposed to infective endocarditis (IE). Patients and methods Retrospective study of tertiary centre Congenital Heart Disease database; to compare incidence of IE in three different types of valved conduits in RVOT: Melody valved stent, cryopreserved homograft (European Homograft Bank) and Contegra graft (Medtronic Inc). Results Between 1989 and 2013, 738 conduits were implanted in 677 patients. 107 Melody valved stents were implanted in 107 patients; IE occurred in 8 (7.5%) patients during a follow-up of 2.0 years (IQR 2.4 years, range 0.3–7.8 years). 577 Homografts were implanted in 517 patients; IE occurred in 14 patients (2.4%) during a median follow-up of 6.5 years (IQR 9.2 years; range 0.1–23.7 years). Finally, 54 Contegra grafts were implanted in 53 patients; 11 patients (20.4%) had IE during a follow-up of 8.8 years (IQR 7.7 years; range 0.2–3.5 years). Survival free of IE by Kaplan–Meier for homografts was 98.7% at 5 years and 97.3% at 10 years; for Contegra 87.8% at 5 years and 77.3% at 10 years and for Melody 84.9% at 5 years (log-rank test; p<0.001). Conclusions The Contegra conduit and Melody valved stents have a significantly higher incidence of IE than homografts. IE is a significant threat for long-term conduit function.