[Aortic valve replacement in children].
From January 1970 to January 1993, 47 aortic valve replacements have been performed in children aged 166.8 +/- 50 months. The valvular pathology was congenital in 39 patients and associated cardiac anomalies were present in 31 cases. 30 children had a previous surgical procedure on the aortic outflow. Seven bioprosthesis and 40 mechanical valves have been implanted. At the time of surgery, an additional major cardiac correction has been performed on 17 occasions (Konno, Bentall, Fontan, correction of truncus arteriosus etc.). While no death occurred in the group subjected only to aortic valve replacement, 7 of the 17 patients where a major cardiac procedure was added died. During a mean follow-up of 61.2 +/- 59.1 months, 3 late deaths occurred, 2 of them non related to valvular surgery. Three reoperations have been performed, in two instances for replacing a degenerated bioprosthesis. One thromboembolic event occurred as well as one temporary episode of haemolytic anaemia. No haemorrhagic complication has been observed. While the results of isolated aortic valve replacement in children are excellent, the risk for hospital death is increased substantially when a major cardiovascular procedure is added to valve replacement, and because of rapid deterioration, the heterografts are now contra-indicated in children.
Saro-Servando
E
E
Service de Chirurgie Cardiovasculaire, Hôpital Sainte-Justine, Côte Sainte-Catherine, Montréal, Québec, Canada.
Vobecky
S
S
Chartrand
C
C
D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000151:congenital / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D006350:Heart Valve Prosthesis / Q000401:mortality*; D006801:Humans; D011183:Postoperative Complications; D012189:Retrospective Studies
Remplacement valvulaire aortique chez l'enfant.