title: [Prosthetic valve replacement in pediatric patients: analysis of 105 cases].
abstract: OBJECTIVE
  To summarize the experience in prosthetic valve replacement in pediatric patients.
  
  
  METHODS
  The clinical data of consecutive 105 children, 63 male and 42 female, aged 13 +/- 3 (1.5-16), with the underlying diseases of rheumatic heart disease (n = 55), congenital heart diseases (n = 43), and infective endocarditis (n = 5), with the preoperative cardiac function of class II (n = 36), or class III or IV (n = 69), who underwent prosthetic valve replacement, including replacement of mitral valve (n = 58), aortic valve (n = 28), tricuspid valve (n = 5), mitral and aortic valves (n = 13), and mitral and tricuspid valves (n = 1), and tricuspid valvuloplasty (n = 26), from May 1984 to May 2004, were respectively analyzed. Mechanical valves were used and took low dose anticoagulant warfarin was administrated to all cases. Postoperatively prothrombin time (PT) and international normal ratio (INR) were observed. Follow-up lasting 10 +/- 4 years (6 months to 20 years) was performed among 100 discharged patients with a follow-up rate of 91.0%.
  
  
  RESULTS
  There were 5 early deaths (4.8%), mostly owing to serious low cardiac output syndrome, and 4 late deaths owing to endocarditis (n = 2), heart failure (n = 1), and serious arrhythmia (n = 1). The 87 surviving patients showed their cardiac function of class I-III. No serious complications related to anticoagulation and prosthesis dysfunction had been found.
  
  
  CONCLUSIONS
  Prosthetic valve replacement with mechanical valve can be performed in pediatric patients with good outcome. Larger type of mechanical valve should be used as possible. Additional surgical procedures may be required to correct the concomitant malformations during the operation. Postoperative long-term low dose anticoagulant treatment is safe.
authors.affiliation: Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South University, Hunan Provincial Institute of cardiovascular Diseases, Changsha 410011, China.
authors.forename: Chao-zhong
authors.initials: CZ
authors.lastname: Long
authors.forename: Xin-min
authors.initials: XM
authors.lastname: Zhou
authors.forename: Jian-guo
authors.initials: JG
authors.lastname: Hu
authors.forename: Bang-liang
authors.initials: BL
authors.lastname: Yin
authors.forename: Yi-feng
authors.initials: YF
authors.lastname: Yang
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.forename: Jin-fu
authors.initials: JF
authors.lastname: Yng
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies