[The surgical treatment of congenital valve disease]

The clinical results after surgical treatment of congenital valve disease have improved due to the use of several recently developed techniques. The replacement of tendinous cords using E-PTFE sutures has allowed the indications for the repair of mitral valve prolapse to be extended. The Ross procedure has made it possible to replace the aortic valve associated with small aortic annulus. However, replacement with a prosthetic valve remains the only option if repair is not possible or fails. Prosthetic valve replacement in the pediatric age-group remains challenging in patients with a small valve annulus. A number of techniques can be employed in such cases, including enlargement of the aortic annulus and translocation of the prosthetic valve in the left atrium, although there are limits on the size of the prosthesis. Further improvement of surgical techniques is necessary, along with the development of prosthetic valves using more nearly physiological materials.