Our Summary

This study looked at how long large pig heart valves (called porcine bioprostheses) last when they are used to replace human pulmonary valves. Over a 17-year period, 203 patients received this type of valve replacement. The main focus was to see how long these patients could go without needing another replacement. Of the 203 patients, 20 needed a second operation between 3.4 and 12 years after the initial replacement. The reasons for needing another operation included leakage, narrowing, a combination of the two, or an infection. The study found that 5 years after the initial operation, 97% of patients were still doing well without needing another operation and at 10 years, 82% were still doing well. The study also found that younger patients and those with smaller valves were more likely to need a second operation. The study concluded that these large pig heart valves are generally very reliable, especially in teenagers and adults. The size of the valve didn’t seem to affect how long it lasted, but the researchers noted that the low number of patients needing a second operation might have affected this finding.

FAQs

  1. How long do large pig heart valves generally last when used in human pulmonary valve replacements?
  2. What factors were found to increase the likelihood of needing a second operation after a pulmonary valve replacement?
  3. Did the size of the valve affect how long it lasted in pulmonary valve replacements?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pulmonary valve replacement is to monitor for any signs of leakage, narrowing, or infection in the years following the surgery. It is important to follow up regularly with your healthcare provider to ensure the valve is functioning properly and to address any issues that may arise. Additionally, younger patients and those with smaller valves should be especially vigilant in monitoring their symptoms, as they may be at a higher risk for needing a second operation. Overall, the study suggests that large pig heart valves are generally reliable for pulmonary valve replacement, but it is important to be proactive in monitoring your health post-surgery.

Suitable For

Patients who are typically recommended for pulmonary valve replacement are those with congenital heart defects, pulmonary valve stenosis, pulmonary valve regurgitation, or other conditions that affect the function of the pulmonary valve. These patients may experience symptoms such as shortness of breath, chest pain, fatigue, or fainting due to their heart condition.

In this specific study, patients who received a porcine bioprosthesis for pulmonary valve replacement were generally teenagers and adults. Younger patients and those with smaller valves were more likely to need a second operation, indicating that these factors may play a role in determining the need for repeat valve replacement.

Overall, patients who are experiencing symptoms related to their pulmonary valve dysfunction and are not responding well to other treatment options may be recommended for pulmonary valve replacement. The decision to undergo valve replacement surgery is typically made after careful consideration of the patient’s individual medical history, symptoms, and overall health.

Timeline

Before pulmonary valve replacement:

  • Patient experiences symptoms such as shortness of breath, chest pain, fatigue, and fainting due to a malfunctioning pulmonary valve
  • Patient undergoes diagnostic tests such as echocardiogram, MRI, and cardiac catheterization to determine the severity of the valve dysfunction
  • Patient and healthcare team decide that pulmonary valve replacement is necessary to improve symptoms and heart function
  • Patient undergoes pre-operative evaluations and preparations for the surgery, including blood tests, imaging studies, and consultation with the surgical team

After pulmonary valve replacement:

  • Patient undergoes surgery to replace the malfunctioning pulmonary valve with a porcine bioprosthesis
  • Patient is monitored in the hospital post-operatively for any complications and to ensure proper healing
  • Patient undergoes rehabilitation and physical therapy to regain strength and endurance
  • Patient is advised to follow up with their healthcare team regularly for monitoring of the new valve and heart function
  • Patient may need to take medications to prevent blood clots and manage any underlying heart conditions
  • Patient gradually resumes normal activities and experiences improved symptoms such as increased exercise tolerance and reduced chest pain
  • Patient may need a second operation in the future if the new valve deteriorates or malfunctions, but the study suggests that these porcine bioprostheses are generally reliable and durable for a significant period of time

What to Ask Your Doctor

  1. What are the risks and benefits of pulmonary valve replacement surgery?
  2. How long can I expect the replacement valve to last before needing another operation?
  3. Are there any lifestyle changes or restrictions I need to follow after the surgery?
  4. What symptoms should I watch out for that may indicate a problem with the replacement valve?
  5. Will I need to take any medications after the surgery, and if so, for how long?
  6. How often will I need follow-up appointments to monitor the function of the replacement valve?
  7. Are there any alternative treatment options to pulmonary valve replacement that I should consider?
  8. What is the recovery process like after the surgery, and how long until I can return to normal activities?
  9. How experienced is the medical team in performing pulmonary valve replacement surgeries?
  10. Are there any specific factors in my medical history that may affect the success of the surgery or the longevity of the replacement valve?

Reference

Authors: Maeda K, Lui GK, Zhang Y, Maskatia SA, Romfh A, Yarlagadda VV, Hanley FL, McElhinney DB. Journal: Semin Thorac Cardiovasc Surg. 2022 Autumn;34(3):994-1000. doi: 10.1053/j.semtcvs.2021.03.044. Epub 2021 May 8. PMID: 33971298