[Implantation of mechanical prosthetic valves in the pediatric age group. Review of the last ten years].
Our aim is to evaluate the outcome of 13 patients, under the age of 18, who underwent 15 valve replacements with mechanical prostheses, from January 1985 through December 1995, in our Hospital. The mean age was 11.7 +/- 5.0 years (from eight months to 18 years); six patients were male. The follow-up was five months to 9.5 years. All of them were initially in NYHA classes III or IV, under medical therapy. Indication for valve replacement was rheumatic valve disease in five and congenital in eight. The mitral valve was replaced in eight patients, the aortic in three and both valves in two patients. Two patients (15%) died in the early post operative period. After the procedure there was a remarkable hemodynamic improvement of the remaining patients; the echocardiographic evaluation showed good left ventricular function in all patients and a reduction in systolic pressure of the pulmonary artery and dimensions of the right chambers of the heart. Two patients had perivalvular leaks. Nine patients were NYHA functional class I, one in class II and one in class III. All patients received warfarin anticoagulation and antibiotic prophylaxis for infective endocarditis. There was no incidence of anticoagulant related haemorrhage or thromboembolic or infectious events. One patient (7.6%) underwent valve replacement as the first procedure; the others underwent valvuloplasty before replacement of the valve. Although valve replacement in this population should only take place when conventional forms of therapy fail, in our group we observed low mortality and morbidity rates.
Serviço de Cardiologia Pediátrica, Hospital de Santa Cruz, Carnaxide.
T
T
Castilho
I
I
Menezes
J
J
Queirós e Melo
R
R
Anjos
F M
FM
Martins
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
Implantação de próteses valvulares mecânicas em idade pediátrica. Revisão dos últimos dez anos.