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Eur J Cardiothorac Surg 2006;30:33-34
© 2006 Elsevier Science NL

Editorial comment

A mechanical prosthesis for pulmonary valve replacement?

Department of Cardiothoracic Surgery, D6-26, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands

^_* Tel.: +31 71 5262348; fax: +31 71 5248284. (Email: m.g.hazekamp@lumc.nl).

The first 20% of the full text of this article appears below.

Usually, for pulmonary valve replacement and RVOT reconstruction, homografts or valved xenografts are used. This is true both for pediatric and adult patients.

Pediatric cardiac surgeons have a tradition of using homografts or biological valved conduits and are inclined to choose the same type of prosthesis when performing pulmonary valve replacement in adult patients with congenital heart disease. The choice for a homograft or xenograft is based on various arguments.

Mechanical valve prostheses carry a life-long risk of thrombo-embolic events even with proper anticoagulative therapy. At the same time anticoagulation has a certain incidence of bleeding complications. Young female patients with child wish are better off without anticoagulation. Furthermore, several reports have reported thrombosed mechanical valves in pulmonary position. The risk of one or more reoperations to replace the homograft or xenograft is usually considered to be sufficiently low to justify the decision of not using a mechanical prosthesis.

The number of grown-up patients with congenital heart disease (GUCH's) is expected to grow in . . . [Full Text of this Article]