[Prosthetic valve replacement in children].
Between 1975 and 1998, 27 patients aged 3 months to 14 years underwent replacement of the aortic, mitral, tricuspid, and pulmonary valves. Five different types of prosthetic valves were used; three were mechanical valves and two were bioprosthetic valves. There were 3 hospital deaths. Among the 24 survivors there were 4 late deaths. Arrhythmia requiring pacemaker implantation occurred in 2 cases after AVR and TVR. Thromboembolic events occurred in 3 patients, all with mechanical valves in pulmonary position. Infective endocarditis occurred in 1 patient after PVR with a mechanical valve. No bleeding complication occurred among the patients on a regimen of Coumadin and Dipyridamole. Two patients, both with Hancock bioprosthesis, required a second valve replacement on account of severely calcified changes. Mechanical valves in left side heart had a satisfactory long-term performance. One patient who had undergone MVR for congenital parachute mitral valve received reoperation for growth. A larger sized prosthetic valve should be used at the first replacement, and special procedures including supra-annular positioning or annular augmentation are recommended for MVR or AVR respectively.
Sasahashi
N
N
Department of Cardiovascular Surgery, Hyogo Kenritsu Amagasaki Hospital, Japan.
Ando
F
F
Okamoto
F
F
Hanada
M
M
Yamanaka
K
K
Kameyama
T
T
Nishigaki
Y
Y
Hirose
K
K
Kambara
A
A
Sakazaki
H
H
Suzuki
T
T
Makino
S
S
D000293:Adolescent; D001021:Aortic Valve / Q000601:surgery; D001705:Bioprosthesis; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000145:classification / Q000592:standards*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D011664:Pulmonary Valve / Q000601:surgery; D014261:Tricuspid Valve / Q000601:surgery