Mid- And Long-Term Follow Up Of Repeat Right Ventricular Outflow Tract Reconstruction Using The Medtronic Freestyle Porcine Aortic Root

Purpose: A stentless porcine aortic root bioprosthesis has been primarily used at Cook Children’s Medical Center (CCMC) for right ventricular outflow tract (RVOT) reconstruction. The purpose of this research was to quantify longevity of the Medtronic Freestyle Porcine Aortic Root and the predictors of its longevity. Methods: A retrospective chart review was conducted of all RVOT reconstructions using porcine aortic root at CCMC between 2002 and 2015. Patients who had a Ross procedure or who were lost to follow up within one year were excluded. For each patient, gender, age, weight, body surface area (BSA), and valve size were abstracted from medical charts. Additionally, survival and reintervention data were captured. Overall freedom from earlier reintervention was assessed using the Kaplan-Meier method. Predictors of longevity were examined with Cox regression. Results: There were 194 operations performed on 188 patients. Excluding patients with Ross procedures, those lost to follow up, and three patients who had died from unrelated causes, 163 patients were examined. Thirty-eight patients (23.3%) required earlier reintervention. The 5-year freedom from reintervention rate was 93.2% (95% CI 86.7-96.6%), and the 10-year rate was substantially lower at 48.4% (95% CI 34.9-60.6%). Regression analyses revealed that age years, weight kg, BSA Conclusions: These data suggest that younger and smaller patients are significantly more likely to require earlier reintervention, but sex is not affiliated with need for earlier reintervention. Upon comparison to other studies, the Freestyle valve’s longevity is comparable to alternative valve replacements.