Early Concerning Outcomes for the Edwards Inspiris Resilia Bioprosthesis in the Pulmonary Position.

Autor:	Said SM; Division of Pediatric Cardiovascular Surgery, Department of Surgery, Maria Fareri Children's Hospital, Westchester Medical Center, Valhalla, New York; Faculty of Medicine, Alexandria University, Alexandria, Egypt. Electronic address: sameh.said@wmchealth.org., Hiremath G; Division of Pediatric Cardiology, Masonic Children's Hospital, University of Minnesota, Minneapolis, Minnesota., Aggarwal V; Division of Pediatric Cardiology, Masonic Children's Hospital, University of Minnesota, Minneapolis, Minnesota., Bass J; Division of Pediatric Cardiology, Masonic Children's Hospital, University of Minnesota, Minneapolis, Minnesota., Sainathan S; Department of Cardiothoracic Surgery, University of Miami, Miller School of Medicine, Miami, Florida., Salem MI; Department of Cardiothoracic Surgery, Port Said University, Port Said, Egypt., Narasimhan S; Division of Pediatric Cardiology, Masonic Children's Hospital, University of Minnesota, Minneapolis, Minnesota.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2023 Apr; Vol. 115 (4), pp. 1000-1007. Date of Electronic Publication: 2022 Sep 27.
DOI:	10.1016/j.athoracsur.2022.09.026
Abstrakt:	Background: The Inspiris Resilia (Edwards Lifesciences LLC) bioprosthesis has gained widespread use in the aortic position; however no robust data are available about its use in the pulmonary position. Methods: We reviewed our outcomes for the Inspiris Resilia in the pulmonary position between August 2019 and October 2021. Results: Twenty-seven patients (15 female patients [56%]; mean age, 22.26 ± 14.99 years) were included. The most common original pathology was tetralogy of Fallot (13 patients, 48%). Five patients (18.5%) had prior transcatheter interventions. The mean right ventricular end-diastolic volume index was 164.25 ± 45.1 mL/m 2 . Sternotomy or repeat sternotomy was the most common approach (21 patients, 77.8%). The standard technique for pulmonary valve replacement was used in 22 patients (81.5%), whereas the prosthesis was implanted as a conduit in the remaining 5 (18.5%). Trivial to mild prosthetic regurgitation was present in 6 patients (22.2%) at the time of discharge. There was no early mortality. Follow-up was complete in all patients (mean, 16 ± 8 months), with no late mortality or late reoperations. New prosthetic regurgitation developed in 13 patients (48%), all of whom underwent replacement with the standard surgical technique. No regurgitation occurred in the conduit cases. This progressed to moderate regurgitation in 6 patients (22%) and severe in 3 (11%). Three patients (11%) underwent transcatheter valve-in-valve after their surgical pulmonary valve replacement. Conclusions: The early data regarding the Inspiris Resilia bioprosthesis use in the pulmonary position is concerning. The prosthesis design may not be suitable for low-pressure circulation, or modification of its implantation technique may be needed. (Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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