Early Onset of Inspiris Resilia Valve Regurgitation After Pulmonary Valve Replacement

<b>Background:</b> We aimed to evaluate the clinical performance of the Inspiris Resilia valve in the pulmonic position. <b>Methods:</b> This study includes adult patients with congenital heart disease (CHD) who underwent pulmonary valve replacement (PVR) using the Inspiris Resilia or Carpentier-Edwards (CE) valve at Kyushu University Hospital from 2004 to 2023, as well as adult patients who underwent aortic valve replacement (AVR) using the Inspiris Resilia valve from 2018 to 2023. We compared the outcomes of the Inspiris Resilia and CE valves at the pulmonic position, and the outcomes of the Inspiris Resilia valves in the pulmonic and aortic position. The primary endpoint was freedom from mild valve regurgitation. <b>Results:</b> There was no significant difference in the freedom from at least moderate pulmonary regurgitation (PR) or stenosis between the Inspiris Resilia and CE valves (<i>P</i> = .65). However, the progression to mild PR in the Inspiris Resilia valve occurred significantly earlier (<i>P</i> = .03), particularly when implanted in the native right ventricular outflow tract (RVOT) (<i>P</i> = .01). The freedom from at least mild aortic regurgitation following AVR with or without using a composite valve graft showed no significant difference (<i>P</i> = .92). <b>Conclusions:</b> This study showed good results for PVR with the Inspiris Resilia valve in adult patients with CHD, but also early onset of mild PR after PVR raising concerns about the long-term durability of the Inspiris Resilia valve, especially when it is implanted in the native RVOT. We recommend that patients who have undergone PVR with the Inspiris Resilia valve in the native RVOT be closely monitored.