Clinical outcomes of injectable and conventional pulmonary valve replacement in severe pulmonary regurgitation.

BACKGROUND/AIM: Pulmonary regurgitation following tetralogy of Fallot repair is a common long-term complication requiring pulmonary valve replacement. Injectable bioprosthetic valves offer a less invasive alternative to conventional surgical replacement, but comparative data in pediatric populations remain limited. This study aimed to evaluate short-term and long-term clinical outcomes of injectable pulmonary valve replacement and conventional pulmonary valve replacement in pediatric patients with severe pulmonary regurgitation following tetralogy of Fallot repair.

MATERIALS AND

METHODS

This retrospective study included 22 pediatric patients who underwent pulmonary valve replacement. Patients were divided into injectable (n = 9) and conventional (n = 13) groups based on anatomical criteria. Primary outcomes included early postoperative parameters and long-term valve function. The mean follow-up duration was 10.5 ± 2.5 years.

RESULTS

Favorable early outcomes were noted in the injectable pulmonary valve replacement cohort, including shorter intensive care unit stay (16.8 ± 6.2 vs. 37.0 ± 23.4 h, p = 0.021), reduced mechanical ventilation duration (5.2 ± 3.9 vs. 15.4 ± 11.4 h, p = 0.019), decreased chest tube drainage (206.7 ± 108.2 vs. 513.1 ± 274.1 mL, p = 0.005), and shorter hospital stay (5.4 ± 2.4 vs. 8.4 ± 3.1 days, p = 0.026). Long-term outcomes indicated similar valve function and right ventricular remodeling in the two groups, with excellent freedom from reintervention (100%) during follow-up.

CONCLUSION

Injectable pulmonary valve replacement appears to be a safe alternative, offering favorable early outcomes and long-term valve performance comparable to conventional methods. However, clinical experience and precise patient selection remain critical for achieving optimal results.