title: Aortic valve replacement with biological substitutes in children.
abstract: BACKGROUND
  this study was performed to assess the results of aortic valve replacement in children with biological substitutes including homografts, pulmonary autografts (Ross procedure), and aortic valve reconstruction with autologous pericardium (Duran technique).
  
  
  METHODS
  between March 1992 and July 2009, 73 children with aortic valve disease (mean age, 11.8 ±2.7 years) underwent aortic valve replacement with biological substitutes including homografts, pulmonary autografts, and aortic valve reconstruction with autologous pericardium. Associated procedures were mitral valve repair in 32 and subaortic membrane resection in 3.
  
  
  RESULTS
  early mortality was 1.4% (1 patient). Median follow-up was 94 months. Sixty (83.3%) survivors had insignificant aortic regurgitation. Reoperation was required in 7 (9.6%) patients: for autograft dysfunction alone in 2, autograft failure and failed mitral valve repair in 2, autograft dysfunction with severe pulmonary homograft regurgitation in 1, severe homograft aortic valve regurgitation in 1, and right ventricular outflow tract obstruction in 1. There were 4 (5.4%) late deaths. Actuarial reoperation-free, event-free, and aortic valve dysfunction-free survival were 92.5% ±4%, 93.4% ±3.3 %, 94% ±2.9%, 86.2% ±4.3%, respectively, at 94 months.
  
  
  CONCLUSIONS
  aortic valve replacement with biological substitutes is associated with acceptable hemodynamics and midterm results.
authors.affiliation: Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. sachintalwar@hotmail.com
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Malankar
authors.forename: Sanket
authors.initials: S
authors.lastname: Garg
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Choudhary
authors.forename: Anita
authors.initials: A
authors.lastname: Saxena
authors.forename: Devagourou
authors.initials: D
authors.lastname: Velayoudham
authors.forename: Arkalgud Sampath
authors.initials: AS
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D001705:Bioprosthesis; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D010496:Pericardium / Q000637:transplantation*; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000637:transplantation*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000209:etiology / Q000601:surgery