Clinical outcomes of injectable and conventional pulmonary valve replacement in severe pulmonary regurgitation
Turkish Journal of Medical Sciences, cilt.56, sa.3, ss.778-786, 2026 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 56 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.55730/1300-0144.6211
- Dergi Adı: Turkish Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.778-786
- Anahtar Kelimeler: congenital heart defects, heart surgical procedure, pulmonary regurgitation, pulmonary valve, Tetralogy of Fallot
- Gazi Üniversitesi Adresli: Evet
Özet
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.