Results of Pulmonary Valve Replacement with a Newly Introduced Bioprosthesis in Children and Young Adults with Congenital Heart Disease

Background: The durability of bioprostheses in the pulmonary position in patients with congenital heart disease remains suboptimal. The new INSPIRIS Resilia aortic valve is characterized by a pericardial tissue that could improve hemodynamic performance and durability. We report initial experience with this valve in the pulmonary position in children and young patients. Methods: A retrospective study was performed. Demographic, clinical, and echocardiographic data were recorded at hospital stay and through follow-up. Results: Between June 2017 and October 2019, 21 patients (14 males) underwent implantation of an INSPIRIS Resilia bioprosthesis. The most common diagnosis was repaired tetralogy of Fallot (n = 14). Mean age was 31 +/- 16.6 years. Seven patients were children (the youngest 4 years old). One patient with tetralogy of Fallot and preoperative right ventricular failure died after surgery from multiorgan failure. No patient had a permanent pacemaker after surgery or other major complications. Early echocardiograms depicted a mean peak gradient across the valve of 17 +/- 7.23 mm Hg, with no paravalvular leaks. At a median follow-up of 20 months (range 1-29 months), all discharged patients were alive without clinical complications. Most recent echocardiograms show good gradients with no paravalvular leaks. Conclusions: In our experience, the INSPIRIS Resilia aortic valve in the pulmonary position provides excellent in-hospital and short-term results in children and young patients with congenital heart disease. Despite showing here one of the longest followups with this prosthesis, longer investigations are required to assess its durability and the feasibility of valve-in-valve procedures in this challenging population.