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Prosthetic valve replacement in children.

H C Stansel, D B Nudel, M A Berman

    Archives of Surgery (Chicago, Ill. : 1960)
    |November 11, 1975
    PubMed
    Summary
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    Prosthetic valve replacement in children shows promising results with low operative mortality and good long-term outcomes, even without routine anticoagulation. This procedure is recommended for children with severe valvular malfunction unresponsive to medical management.

    Area of Science:

    • Pediatric Cardiology
    • Cardiovascular Surgery
    • Biomaterials Science

    Background:

    • Previous studies indicated high operative mortality for prosthetic valve replacement in pediatric patients.
    • Valvular heart disease in children presents unique challenges for surgical intervention.

    Purpose of the Study:

    • To evaluate the clinical experience and outcomes of prosthetic valve replacement in a pediatric population.
    • To assess the feasibility and safety of prosthetic valve implantation in children.

    Main Methods:

    • Surgical implantation of 25 prosthetic valves in 24 pediatric patients.
    • Retrospective analysis of operative mortality, late mortality, and long-term complications.
    • Assessment of embolism rates in patients not undergoing elective anticoagulation.

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    Main Results:

    • One operative death occurred in 24 patients (4.1% operative mortality).
    • One late death was attributed to pacemaker malfunction; other patients demonstrated excellent long-term outcomes.
    • The long-term embolism rate did not exceed that observed in adults on warfarin therapy.

    Conclusions:

    • Prosthetic valve replacement in children can be performed with acceptable operative mortality and favorable long-term results.
    • Myocardial preservation is a key objective, achievable with current prostheses.
    • Valve replacement should be considered for pediatric patients with valvular malfunction refractory to medical management.