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  1. Home
  3. Is Redo Complete Valved Pulmonary Trunk Replacement A Safe And Effective Approach?
  1. Home
  3. Is Redo Complete Valved Pulmonary Trunk Replacement A Safe And Effective Approach?

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Is Redo Complete Valved Pulmonary Trunk Replacement a Safe and Effective Approach?

Tomislav Cvitkovic1, Murat Avsar1, Theresa Holst2

  • 1Hannover Medical School, Departement for Cardiac, Thoracic, Transplantation and Vascular Surgery, Germany, Hannover.

The Thoracic and Cardiovascular Surgeon
|May 12, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Redo pulmonary valve replacement (PVR) in adults with congenital heart disease shows outcomes similar to first-time PVR, despite increased surgical complexity. Endocarditis is a key risk factor in repeat PVR procedures.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Adult Congenital Heart Disease

Background:

  • Pulmonary valve replacement (PVR) is the most frequent cardiac surgery for adults with congenital heart disease (ACHD).
  • A significant majority (96%) of these PVR procedures are repeat surgeries.
  • Understanding outcomes for multiple PVRs is crucial for managing ACHD patients.

Purpose of the Study:

  • To compare operative and early postoperative outcomes of first-time, second-time, and third-or-more-time PVR.
  • To evaluate the impact of surgical complexity on patient outcomes in redo PVR.

Main Methods:

  • Retrospective analysis of 104 adult ACHD patients undergoing total valved pulmonary trunk replacement.
  • Data collected between January 2014 and March 2022.
  • Comparison of outcomes based on the number of previous PVRs.

    • Main Results:

    • Operative times (bypass and cross-clamp) significantly increased with each subsequent PVR.
    • Postoperative length of stay was longer for patients with more prior PVRs.
    • Despite increased complexity, no significant differences in complications, gradients, or regurgitation were found between groups. Mortality was low, with endocarditis a risk in redo cases.

    Conclusions:

    • Multiple PVRs in ACHD patients yield early clinical outcomes comparable to first-time PVR.
    • Increased surgical complexity in redo PVR does not translate to worse early outcomes.
    • Endocarditis is a significant risk factor that requires careful consideration in redo PVR surgery.