title: Valve replacement in children under 14 years of age: a review of 22 years of experience.
abstract: From 1964 to 1986, a total of 18 valve replacement operations were performed in 15 children under 14 years of age, with 13% operative mortality. Eleven children had a mitral valve replacement, with 3 subsequently requiring reoperation. Twelve Starr-Edwards caged ball prostheses, 1 Björk-Shiley and 1 Carpentier-Edwards prosthesis were implanted in the mitral position, with 18% operative mortality. Three children underwent aortic valve replacement, 1 with a Björk-Shiley prosthesis and 2 with a Starr-Edwards. One patient had tricuspid valve replacement utilizing a Starr-Edwards valve. Thirteen patients had one or more cardiac operations prior to valve replacement. Two late deaths occurred 8 and 18 months, respectively, group, 1 from a cardiac arrhythmia and 1 from fulminating prosthetic valve endocarditis. There were no late deaths in other patients. There was one thromboembolic episode in the entire group. At follow-up, 10 patients were classified as New York Heart Association Functional Class I and 1 patient was Class III. Valve replacement in children can be carried out with low mortality and good long-term results using the Starr-Edwards caged ball prosthesis.
authors.affiliation: Heart Institute, St. Vincent Hospital and Medical Center, Portland, Oregon.
authors.forename: L
authors.initials: L
authors.lastname: Guvendik
authors.forename: A
authors.initials: A
authors.lastname: Cobanoglu
authors.forename: N R
authors.initials: NR
authors.lastname: Davis
authors.forename: C L
authors.initials: CL
authors.lastname: Fessler
authors.forename: A
authors.initials: A
authors.lastname: Starr
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D014261:Tricuspid Valve / Q000601:surgery*