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Long-term Results Of Right Ventricular Outflow Tract Reconstruction Using Bicuspid Cormatrix Pulmonary Valve
Chawki Elzein, MD1, Narutoshi Hibino, MD, PHD2, Umar Siddiqi2, Luca Vricella, MD1, Michel Ilbawi, MD1.
1Advocate Children's Hospital, Oak Lawn, IL, USA, 2University of Chicago, Chicago, IL, USA.

Objective(s):There is no ideal patch material for reconstruction of the right ventricular outflow tract(RVOT)in patients with congenital heart diseases.CorMatrix proved to be a suboptimal patch material for reconstruction of the aortic and mitral valves.We present the long-term results of bicuspid CorMatrix pulmonary valve(PV)in patients with congenital heart diseases.
Methods: :Single center retrospective review of all patients undergoing RVOT reconstruction with creation of a bicuspid PV between 10/2012 and 2/2021.The patch material used was CorMatrix (n=38,group A),autologous pericardium (n=5,group B)and Gore-Tex(n=5,group C).
Results:Baseline characteristics were similar except for lower mean weight(4.8kg)and longer mean ICU stay(10 days)in group B.Despite longer follow up period for group A(group A 1678852,group B 158160,group C 639234 days),pulmonary stenosis(PS)gradient progressed faster in group C(group A 3722, group B 20,group C 5517 mmHg,p=0.15).Pulmonary regurgitation(PR)grade was the same(group A 2.91.3,group B 3,group C 2.60.5,p=0.67).Freedom from catheter intervention(group A 84% at 2 years,59% at 5 years,group C 0% at 2 years,p<0.0001)and reoperation (group A 92% at 2 years,75% at 5 years,group C 80% at 2 years,p<0.0001)were significantly higher for CorMatrix compared with Gore-Tex.Cox regression analysis showed CorMatrix to have less need for intervention(HR 0.08,p=0.03)and branch pulmonary artery stenosis increases the need for catheter intervention(HR 8.6,p<0.0001)and reoperation(HR 9.16, p<0.0001)on the PV.
Conclusions:CorMatrix is a good alternative for PV reconstruction in patients with congenital heart diseases.Branch pulmonary artery stenosis decreases the longevity of the bicuspid PV function.


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