{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:59Z","timestamp":1787018099876,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,12,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Tetralogy of Fallot repair results in late occurrence of pulmonary regurgitation, which requires pulmonary valve replacement in a large proportion of patients. Both homografts and bioprostheses are used for pulmonary valve replacement as uncertainty remains on which prosthesis should be considered superior. We performed a long\u2010term imaging and clinical comparison between these 2 strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We compared echocardiographic and clinical follow\u2010up data of 209 patients with previous tetralogy of Fallot repair who underwent pulmonary valve replacement with homograft (n=75) or bioprosthesis (n=134) between 1995 and 2018 at a tertiary hospital. The primary end point was the composite of pulmonary valve replacement reintervention and structural valve deterioration, defined as a transpulmonary pressure decrease \u226550\u00a0mm\u00a0Hg or pulmonary regurgitation degree of \u22652. Mixed linear model and Cox regression model were used for comparisons. Echocardiographic follow\u2010up duration was longer in the homograft group (8 [interquartile range, 4\u201312] versus 4 [interquartile range, 3\u20136] years;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). At the latest echocardiographic follow\u2010up, homografts showed a significantly lower transpulmonary systolic pressure decrease (16\u00a0[interquartile range, 12\u201325] mm Hg) when compared with bioprostheses (28\u00a0[interquartile range, 18\u201341] mm Hg; mixed model\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and a similar degree of pulmonary regurgitation (degree 0\u20104) (1 [interquartile range, 0\u20132] versus 2 [interquartile range, 0\u20132]; mixed model\n                      <jats:italic>P<\/jats:italic>\n                      =0.19). At 9\u00a0years, freedom from structural valve deterioration and reintervention was 81.6% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 71.5%\u201391.6%) versus 43.4% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 23.6%\u201363.2%) in the homograft and bioprosthesis groups, respectively (adjusted hazard ratio, 0.27; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 0.13\u20130.55;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">When compared with bioprostheses, pulmonary homografts were associated lower transvalvular gradient during follow\u2010up and were associated with a significantly lower risk of reintervention or structural valve degeneration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.013654","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T05:07:15Z","timestamp":1576472835000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Long\u2010Term Comparison Between Pulmonary Homograft Versus Bioprosthesis for Pulmonary Valve Replacement in Tetralogy of Fallot"],"prefix":"10.1161","volume":"8","author":[{"given":"Lucia","family":"Cocomello","sequence":"first","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Meloni","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Rapetto","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Baquedano","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Victoria","family":"Ordo\u00f1ez","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Biglino","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bucciarelli\u2010Ducci","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Parry","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National Health Service Foundation Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serban","family":"Stoica","sequence":"additional","affiliation":[{"name":"Bristol Heart Institute University Hospitals Bristol National 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