title: Stentless xenograft implantation in aortic position in a 7-year-old girl.
abstract: Disease or dysfunction of the aortic valve in pediatric patients presents a substantial challenge. Valve preservation, even if not the definitive solution, is always optimal. Successful repair will enable somatic growth and avoid repeated valve replacement and the need for systemic anticoagulation. When repair of the aortic valve is not possible in pediatric patients, replacement of the valve requires the most suitable (or, often, the least unsuitable) choice for each patient. The limitations of the typical replacement options (pulmonary autografts, mechanical valves, stented bioprostheses, and homografts) have led us to explore the use of stentless xenografts. Herein, we present a case of aortic valve replacement with a stentless porcine xenograft in one of the youngest and smallest patients reported to date. Use of the xenograft enabled a proper fit with a small aortic annulus, precluded the need for subsequent systemic anticoagulation, and averted a transvalvular gradient and the creation of 2-valve disease. We believe that the stentless porcine xenograft is feasible for use in pediatric patients who require aortic valve replacement.
authors.affiliation: Division of Congenital Heart Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Sadik
authors.initials: S
authors.lastname: Sharef
authors.forename: Ryan
authors.initials: R
authors.lastname: Coleman
authors.forename: Shannon
authors.initials: S
authors.lastname: Rivenes
authors.forename: Ivan
authors.initials: I
authors.lastname: Wilmot
authors.forename: Carolyn
authors.initials: C
authors.lastname: Altman
authors.forename: Ramiro
authors.initials: R
authors.lastname: Madden-Fuentes
authors.forename: Jorge
authors.initials: J
authors.lastname: Salazar
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D011474:Prosthesis Design; D020127:Recovery of Function; D013552:Swine; D016896:Treatment Outcome