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Related Experiment Videos

Biological versus mechanical aortic valve replacement in children.

M W Turrentine1, M Ruzmetov, P Vijay

  • 1Section of Cardiothoracic Surgery, James W. Riley Hospital for Children, and Indiana University School of Medicine, Indianapolis 46202-5123, USA. mturren@iupui.edu

The Annals of Thoracic Surgery
|June 5, 2001
PubMed
Summary

Pediatric aortic valve replacement using the Ross procedure (pulmonary autograft) shows promising long-term results and avoids anticoagulation. This study compares it with other prosthetic devices over 27 years.

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Biomaterials Science

Background:

  • Pediatric aortic valve replacement presents challenges due to limited prosthetic options.
  • Anticoagulation risks with mechanical valves and degeneration of biological substitutes drive interest in the Ross procedure.

Purpose of the Study:

  • To evaluate the 27-year experience with various prosthetic devices for aortic valve replacement in children.
  • To compare the outcomes of the Ross procedure (pulmonary autograft) against mechanical valves, aortic homografts, and xenografts.

Main Methods:

  • A retrospective study of 99 pediatric patients undergoing aortic valve replacement between 1973 and 2000.
  • Procedures included pulmonary autograft (PA, n=42), aortic homograft (AH, n=3), mechanical valves (MV, n=41), and xenograft tissue valves (XG, n=13).

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Main Results:

  • The pulmonary autograft group showed a significantly lower incidence of valve-related complications and reoperations (11.9%) compared to mechanical valves (15.2%), xenografts (70%), and aortic homografts (50%).
  • Perioperative outcomes and early deaths were similar across all groups.
  • Actuarial survival rates at 10 years were 87.8% for MV and 100% for XG, while at 7 years, they were 95.2% for PA and 6.6% for AH.

Conclusions:

  • Aortic valve replacement in children can achieve acceptable mortality and good long-term outcomes.
  • The Ross procedure offers advantages including no need for anticoagulation, suitability for all age groups, growth potential, and favorable left ventricular outflow tract hemodynamics, despite its complexity.