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Haas, Nikolaus A.; Bach, Sissi; Vcasna, Radka; Laser, Kai Thorsten; Sandica, Eugen; Blanz, Ute; Jakob, Andre; Dietl, Markus; Fischer, Marcus; Kanaan, Majed; Lehner, Anja (2018): The risk of bacterial endocarditis after percutaneous and surgical biological pulmonary valve implantation. In: International Journal of Cardiology, Vol. 268: pp. 55-60
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Abstract

Objective: This single center study compared the risk of bacterial endocarditis (BE) after surgical and percutaneous pulmonary valve implantation. Methods: Between Jan 1st 2010 and Dec 31st 2015 all patients who received a biological pulmonary valve (surgical/interventional) were identified. The clinical follow-up was analyzed with regard to BE applying the modified Duke criteria and echocardiographic findings. Results: We identified 246 patientswho underwent a biological pulmonary valve implantation. Themean agewas 15.9 years, (SD 12.7, Median 13.1). There were 166 surgical patients (67.5%), with 55 homografts (22.4%, mean diameter 27.4mm), 106 Contegra (R) grafts (43.1%, mean diameter 17.4) and 5 Hancock (R) valves (2.0, mean diameter 25.6 mm) and 80 percutaneous pulmonary valve implantations (PPVI) (32.5%) with 51 Edwards Sapien (R) valves (20.7%, mean diameter 25.2 mm) and 29 Melody (R) valves (11.8%, mean diameter 21.9 mm). Patients with a bovione jugular conduit as the biologiocal substrate had an increased risk for BE and patientswithMelody (R) valves had the highest risk for BE that was 5-8 times higher as compared to other valves. BE episodes were detected in 5/106 Contegras (R) (4,7%, 1.5 per 100 person-years), and in 6/29 of the Melody (R) valves (20.7%, 4.8 per 100 person-years). There were no cases of BE in patients treated with Edwards Sapien (R), homografts or Hankock (R) valves. Conclusion: Whereas homografts and Edwards Sapien (R) valves seem to have a very low risk of BE, this risk is increased in Contegra (R) conduits and in Melody (R) valves.