[Surgery for the valvular disease in children]

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.