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[Surgery for the valvular disease in children]
Insights
This study followed 34 children who had heart valve surgery, finding a 5-year survival rate of 68.6% and 64.7% free from reoperation. Results were satisfactory for patients without complications.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Congenital Heart Disease
Background:
- Valvular heart disease affects children, necessitating surgical intervention.
- Surgical outcomes and long-term follow-up data in pediatric patients are crucial for treatment planning.
Purpose of the Study:
- To report the results and long-term follow-up of pediatric patients undergoing valvular surgery.
- To evaluate survival and reoperation rates after various valvular surgical procedures in children.
Main Methods:
- Retrospective analysis of 34 pediatric patients (12 days to 13 years) who underwent valvular surgery between May 1989 and November 1996.
- Procedures included aortic valvuloplasty/replacement, aortic valvulotomy/replacement, mitral valvuloplasty/replacement, pulmonary valvotomy, and tricuspid valve replacement.
- Actuarial survival and reoperation-free curves were calculated for long-term follow-up.
Main Results:
- Operative mortality was 11.8%.
- Five-year actuarial survival rate was 68.6%, with 64.7% of patients free from reoperation.
- Specific procedures addressed aortic regurgitation, aortic stenosis, mitral regurgitation, pulmonary atresia/stenosis, and tricuspid disease.
- Higher mortality was observed in critical aortic stenosis, severe mitral regurgitation, and tricuspid valve replacement groups.
- Satisfactory results were noted in surviving patients without complications.
Conclusions:
- Valvular surgery in children carries significant risks, including operative mortality and the need for reoperation.
- Long-term survival and freedom from reoperation are achievable, though outcomes vary by specific valve condition and procedure.
- Careful patient selection and management are essential for optimizing results in pediatric valvular surgery.
Abstract:
We report the results and long-term follow up in 34 children (17 girls and 17 boys, aged 12 days to 13 years, average age 3.3 years, average body weight 11.7 kg) who underwent valvular surgery in the period between May 1989 and November 1996. Operative mortality was 11.8%. Actuarial survival curves (including hospital mortality) indicate a 68.6% survival rate at 5 years and that 64.7% of patients are free from reoperation at 5 years. For aortic regurgitation two patients applied aortic valvuloplasty and four applied aortic valve replacement. Nine children had aortic stenosis, three of them had balloon valvuloplasty, seven had valvotomy, two had aortic valve replacement. Ten patients were treated for mitral regurgitation. There were nine valvuloplasty and four mitral valve replacement including three times of reoperation. One membranous pulmonary atresia and seven pulmonary stenosis children had valvotomy. There were four cases of tricuspid disease. One had tricuspid valve stenosis with pulmonary stenosis, three had severe tricuspid regurgitation who applied tricuspid valve replacement. Mortality was high in the critical AS, severe MR and TVR groups. Patients who survived the surgery and had no complications showed satisfiable results.