{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:48:49Z","timestamp":1781765329111,"version":"3.54.5"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Birmingham Women\u2019s and Children\u2019s Hospital Charity","award":["37\u20136-337"],"award-info":[{"award-number":["37\u20136-337"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Many models of bioprosthesis are available for pulmonary valve replacement in adults with congenital heart disease, but there is a lack of randomized evidence to guide practice. We surveyed congenital cardiac surgeons to establish current practice and willingness to change within a clinical trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An online survey was sent to all consultant congenital cardiac surgeons in adult congenital centres in the United Kingdom and Ireland. Information was sought on preferred prostheses, factors influencing decision-making, implant technique, postoperative anticoagulation, practice variations in adolescents, and willingness to randomize patients to different prostheses within a trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Responses were obtained from 27 (69%) surgeons. A total of 19 (70%) preferred an Edwards bovine pericardial valve, most commonly the Inspiris Resilia (7, 26%). Only 2 (7%) favoured the Hancock II valve; the remaining 6 (22%) preferred pulmonary homografts. Data regarding long-term freedom from reintervention (23, 85%) was the most important factor influencing prosthesis choice. A total of 22 (81%) surgeons were willing to randomize adult patients to either a bovine pericardial valve or a porcine xenograft in a clinical trial, with Perimount Magna Ease and Hancock II being the most acceptable, respectively. Willingness to randomize dropped to 11 (41%) surgeons for adolescent patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This survey demonstrates heterogeneity in the choice of pulmonary valve prosthesis. Combined with a lack of evidence from clinical trials, our findings support the presence of clinical equipoise. Most surgeons are willing to change practice, suggesting that a pragmatic, multicentre, randomized controlled trial comparing bovine pericardial versus porcine xenograft for pulmonary valve replacement in adults is feasible.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf214","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T15:51:48Z","timestamp":1758729108000},"source":"Crossref","is-referenced-by-count":1,"title":["Pulmonary Valve Replacement in Adults and Adolescents With Congenital Heart Disease: A United Kingdom and Ireland Survey"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5788-2935","authenticated-orcid":false,"given":"Chris J","family":"Bond","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Queen Elizabeth Hospital Birmingham , Birmingham,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8870-3496","authenticated-orcid":false,"given":"Timothy J","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Queen Elizabeth Hospital Birmingham , Birmingham,","place":["United Kingdom"]},{"name":"Department of Paediatric Cardiac Surgery, Birmingham Children\u2019s Hospital , Birmingham,","place":["United Kingdom"]},{"name":"Department of Cardiovascular Sciences, School of Medical Sciences, College of Medicine and Health, University of Birmingham , Birmingham,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-2116","authenticated-orcid":false,"given":"J Andreas","family":"Hoschtitzky","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery, Royal Brompton Hospital and Evelina London Children\u2019s Hospital , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Viola","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery, Southampton Children\u2019s Hospital , Southampton,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0866-2394","authenticated-orcid":false,"given":"Mark H D","family":"Danton","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery, Royal Hospital for Children , Glasgow,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9012-6683","authenticated-orcid":false,"given":"Nigel E","family":"Drury","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiac Surgery, Birmingham Children\u2019s Hospital , Birmingham,","place":["United Kingdom"]},{"name":"Department of Cardiovascular Sciences, School of Medical Sciences, College of Medicine and Health, University of Birmingham , Birmingham,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"2025101011021886300_ivaf214-B1","author":"National Institute for Cardiovascular Outcomes Research","year":"2024"},{"key":"2025101011021886300_ivaf214-B2","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1016\/j.jacc.2023.02.052","article-title":"Improved outcomes after pulmonary valve replacement in repaired tetralogy of Fallot","volume":"81","author":"Bokma","year":"2023","journal-title":"J Am Coll Cardiol."},{"key":"2025101011021886300_ivaf214-B3","doi-asserted-by":"crossref","first-page":"e000110","DOI":"10.1161\/HCQ.0000000000000110","article-title":"Psychological outcomes and interventions for individuals with congenital heart disease: a scientific statement from the American Heart Association","volume":"15","author":"Kovacs","year":"2022","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2025101011021886300_ivaf214-B4","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2022-002147","article-title":"Research priorities in children and adults with congenital heart disease: a James Lind Alliance Priority Setting Partnership","volume":"9","author":"Drury","year":"2022","journal-title":"Open Heart."},{"key":"2025101011021886300_ivaf214-B5","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1093\/ejcts\/ezu307","article-title":"A comparison of outcomes between bovine pericardial and porcine valves in 38,040 patients in England and Wales over 10 years","volume":"47","author":"Hickey","year":"2015","journal-title":"Eur J Cardiothorac Surg."},{"key":"2025101011021886300_ivaf214-B6","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1016\/j.athoracsur.2019.05.068","article-title":"Outcomes of bioprosthetic valves in the pulmonary position in adults with congenital heart disease","volume":"108","author":"Egbe","year":"2019","journal-title":"Ann Thorac Surg."},{"key":"2025101011021886300_ivaf214-B7","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.jtcvs.2019.11.134","article-title":"Long-term durability of bioprosthetic valves in pulmonary position: pericardial versus porcine valves","volume":"160","author":"Kwak","year":"2020","journal-title":"J Thorac Cardiovasc Surg."},{"key":"2025101011021886300_ivaf214-B8","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":"Baird","year":"2021","journal-title":"J Thorac Cardiovasc Surg."},{"key":"2025101011021886300_ivaf214-B9","doi-asserted-by":"crossref","first-page":"623","DOI":"10.4070\/kcj.2021.0335","article-title":"A bicentric propensity matched analysis of 158 patients comparing porcine versus bovine stented bioprosthetic valves in pulmonary position","volume":"52","author":"Ramchandani","year":"2022","journal-title":"Korean Circ J."},{"key":"2025101011021886300_ivaf214-B10","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/j.athoracsur.2023.07.049","article-title":"Short- and mid-term results of pulmonary valve replacement with the Inspiris valve","volume":"117","author":"Ragheb","year":"2024","journal-title":"Ann Thorac Surg."},{"key":"2025101011021886300_ivaf214-B11","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/0267659118794343","article-title":"Cardioplegia practice in paediatric cardiac surgery: a UK & Ireland survey","volume":"34","author":"Drury","year":"2019","journal-title":"Perfusion."},{"key":"2025101011021886300_ivaf214-B12","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"2025101011021886300_ivaf214-B13","author":"Abbott Laboratories","year":"2023"},{"key":"2025101011021886300_ivaf214-B14","author":"Abbott Laboratories","year":"2023"},{"key":"2025101011021886300_ivaf214-B15","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.jtcvs.2023.09.047","article-title":"Seven-year outcomes following aortic valve replacement with a novel tissue bioprosthesis","volume":"168","author":"Beaver","year":"2024","journal-title":"J Thorac Cardiovasc Surg."},{"key":"2025101011021886300_ivaf214-B16","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/j.athoracsur.2022.09.026","article-title":"Early concerning outcomes for the Edwards Inspiris Resilia bioprosthesis in the pulmonary position","volume":"115","author":"Said","year":"2023","journal-title":"Ann Thorac Surg."},{"key":"2025101011021886300_ivaf214-B17","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/j.jtcvs.2023.04.018","article-title":"Use of the Inspiris valve in the native right ventricular outflow tract is associated with early prosthetic regurgitation","volume":"166","author":"Nguyen","year":"2023","journal-title":"J Thorac Cardiovasc Surg."},{"key":"2025101011021886300_ivaf214-B18","author":"COMMENCE Pulmonary: clinical evaluation of Edwards pericardial aortic bioprosthesis (model 11000A) for pulmonary valve replacement (COMMENCE-P)","year":"2023"}],"container-title":["Interdisciplinary CardioVascular and Thoracic 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