{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:01:39Z","timestamp":1768294899328,"version":"3.49.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"S 03","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":120,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003In patients with tetralogy of Fallot (ToF) or ToF-like anatomy, factors possibly impacting the longevity of biological valves in the pulmonary position were investigated.<\/jats:p><jats:p>\n          Method\u2003Between 1997 and 2017, 79 consecutive hospital survivors with a median age of 8.7 years (range: 0.2\u201356.1 years; interquartile range [IQR]: 14.8 years) with ToF or ToF-like anatomy underwent surgical implantation of Contegra (n\u2009=\u200934), Hancock (n\u2009=\u200923), Perimount (n\u2009=\u20099), pulmonary homograft (n\u2009=\u20099), and miscellaneous (n\u2009=\u20094) conduits. The median internal graft diameter was 19\u2009mm (range: 11\u201329\u2009mm; IQR: 8\u2009mm) which refers to a median z-score of 0.6 standard deviation (SD) (range: \u22121.8 to 4.0 SD; IQR: 2.1 SD).<\/jats:p><jats:p>\n          Results\u2003The median time of follow-up was 9.4 years (range: 1.1\u201318.8 years; IQR: 6.0 years). Thirty-nine patients (49%) underwent surgical (n\u2009=\u200932) or interventional (n\u2009=\u20097) pulmonary valve re-replacement. Univariate Cox regression revealed patient age (p\u2009=\u20090.018), body surface area (p\u2009=\u20090.004), internal valve diameter (p\u2009=\u20090.005), and prosthesis z-score (p\u2009=\u20090.018) to impact valve longevity. Multivariate Cox regression analysis, however, did not show any significant effect (likely related to multicollinearity). Subgroup analysis showed that valve-revised patients have a higher average z-score (p\u2009=\u20090.003) and younger average age (p\u2009=\u20090.007).<\/jats:p><jats:p>\n          Conclusion\u2003A decreased longevity of biological valves in the pulmonary position is related to younger age, lower valve diameter, and higher z-score. Because valve size (diameter and z-score) can be predicted by age, patient age is the crucial parameter influencing graft longevity.<\/jats:p>","DOI":"10.1055\/a-2316-8828","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T22:58:05Z","timestamp":1714517885000},"page":"e1-e6","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["The Ongoing Debate: Longevity of Biological Valves in Pulmonary Position"],"prefix":"10.1055","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7730-6425","authenticated-orcid":false,"given":"Marlene","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Bereich Kinderherzchirurgie\/Chirurgie angeborener Herzfehler, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-8570","authenticated-orcid":false,"given":"Daniel","family":"Biermann","sequence":"additional","affiliation":[{"name":"Bereich Kinderherzchirurgie\/Chirurgie angeborener Herzfehler, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam Mkanyika","family":"Righa","sequence":"additional","affiliation":[{"name":"Bereich Kinderherzchirurgie\/Chirurgie angeborener Herzfehler, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9472-1663","authenticated-orcid":false,"given":"Henning","family":"Carstens","sequence":"additional","affiliation":[{"name":"Bereich Kinderherzchirurgie\/Chirurgie angeborener Herzfehler, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-2683","authenticated-orcid":false,"given":"Rainer Gerhard","family":"Kozlik-Feldmann","sequence":"additional","affiliation":[{"name":"Bereich Kinderkardiologie, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7169-6330","authenticated-orcid":false,"given":"Michael","family":"H\u00fcbler","sequence":"additional","affiliation":[{"name":"Bereich Kinderherzchirurgie\/Chirurgie angeborener Herzfehler, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5279-324X","authenticated-orcid":false,"given":"J\u00f6rg Siegmar","family":"Sachweh","sequence":"additional","affiliation":[{"name":"Bereich Kinderherzchirurgie\/Chirurgie angeborener Herzfehler, Klinik f\u00fcr Kinderherzmedizin und Erwachsene mit angeborenen Herzfehlern, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.14797\/mdcj-15-2-122","article-title":"Pulmonary valve replacement for tetralogy of Fallot","volume":"15","author":"D Balzer","year":"2019","journal-title":"Methodist DeBakey Cardiovasc J"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"3282","DOI":"10.1161\/01.CIR.92.11.3282","article-title":"Prolongation of RV-PA conduit life span by percutaneous stent implantation. Intermediate-term results","volume":"92","author":"A J Powell","year":"1995","journal-title":"Circulation"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.jtcvs.2011.10.079","article-title":"Younger age and valve oversizing are predictors of structural valve deterioration after pulmonary valve replacement in patients with tetralogy of Fallot","volume":"143","author":"P C Chen","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s00246-020-02297-z","article-title":"Tetralogy of Fallot will be treated interventionally within two decades","volume":"41","author":"M RK Rahmath","year":"2020","journal-title":"Pediatr Cardiol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"e010852","DOI":"10.1161\/CIRCINTERVENTIONS.121.010852","article-title":"Long-term outcomes after melody transcatheter pulmonary valve replacement in the US investigational device exemption trial","volume":"15","author":"T K Jones","year":"2022","journal-title":"Circ Cardiovasc Interv"},{"issue":"02","key":"ref6","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1093\/icvts\/ivab233","article-title":"Pulmonary valve prostheses: patient's lifetime procedure load and durability","volume":"34","author":"D Boethig","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jcin.2013.10.012","article-title":"Effect of valve design on the stent internal diameter of a bioprosthetic valve: a concept of true internal diameter and its implications for the valve-in-valve procedure","volume":"7","author":"V N Bapat","year":"2014","journal-title":"JACC Cardiovasc Interv"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.echo.2008.02.006","article-title":"Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study","volume":"21","author":"M D Pettersen","year":"2008","journal-title":"J Am Soc Echocardiogr"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.jtcvs.2020.06.157","article-title":"Reintervention rates after bioprosthetic pulmonary valve replacement in patients younger than 30 years of age: a multicenter analysis","volume":"161","author":"C W Baird","year":"2021","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"ivac197","DOI":"10.1093\/icvts\/ivac197","article-title":"Risk factors for early adverse outcomes after bovine jugular vein conduit implantation: influence of oversized conduit on the outcomes","volume":"35","author":"D H Kim","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1016\/j.jtcvs.2016.06.064","article-title":"Outcome and performance of bioprosthetic pulmonary valve replacement in patients with congenital heart disease","volume":"152","author":"R Nomoto","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.athoracsur.2010.07.111","article-title":"Risk factors for prosthesis failure in pulmonary valve replacement","volume":"91","author":"R Zubairi","year":"2011","journal-title":"Ann Thorac Surg"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1177\/21501351211027857","article-title":"Long-term outcome following pulmonary valve replacement in repaired tetralogy of Fallot","volume":"12","author":"A FH Al Mosa","year":"2021","journal-title":"World J Pediatr Congenit Heart Surg"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1161\/CIRCIMAGING.111.963637","article-title":"Impact of gender and age on cardiovascular function late after repair of tetralogy of Fallot: percentiles based on cardiac magnetic resonance","volume":"4","author":"S Sarikouch","year":"2011","journal-title":"Circ Cardiovasc Imaging"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2316-8828.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T11:34:16Z","timestamp":1730806456000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2316-8828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":14,"journal-issue":{"issue":"S 03","published-online":{"date-parts":[[2024,6,4]]},"published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2316-8828","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,30]]},"published":{"date-parts":[[2024,1]]}}}