title: [Long-term outcome of aortic valve replacement with annular enlargement].
abstract: BACKGROUND
  The choice of appropriate treatment in children with aortic valvular lesions remains controversial. The purpose of this study is to assess early and late outcomes of aortic valve replacement with annular enlargement in children.
  
  
  METHODS
  A retrospective study was conducted in 16 consecutive patients aged 0.26 to 15.9 years operated on between 1993 and 2008. Thirteen children underwent aortic valve replacement with Konno procedure (mechanical valve: 12, homograft: 1), 2 children underwent Ross procedure, and the last child underwent Nicks procedure with mechanical valve replacement. All patients undergoing mechanical valve replacement were given warfarin with a monthly international normalized ratio (INR) control.
  
  
  RESULTS
  Overall early mortality was 12.5% (2 cases). Emergency operation was performed in these cases because of infectious endocarditis and acute cardiac failure. However, cardiopulmonary bypass (CPB) weaning could not be obtained. There was 1 late death 5 months after mechanical valve replacement. The patient developed methicillin-resistant Staphylococcus aureus (MRSA) sepsis after cleft palate repair. Reoperation was needed in 1 case.
  
  
  CONCLUSIONS
  We conclude that mechanical valve replacement with aortic annular enlargement is an acceptable treatment in children. It is associated with acceptable mortality and low incidence of late events, and provides long-term survival.
authors: Division of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
authors: Yoshiyuki
authors: Y
authors: Maekawa
authors: Takahiko
authors: T
authors: Sakamoto
authors: Kentaro
authors: K
authors: Umezu
authors: Nobuo
authors: N
authors: Ohashi
authors: Yorikazu
authors: Y
authors: Harada
authors: Satoshi
authors: S
authors: Yasukochi
authors: Kiyohiro
authors: K
authors: Takigiku
authors: Kota
authors: K
authors: Takei
authors: Yusuke
authors: Y
authors: Nakano
authors: Nao
authors: N
authors: Inoue
authors: Tesshu
authors: T
authors: Otagiri
authors: Yuichiro
authors: Y
authors: Hashida
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome