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Mechanical aortic valve replacement: long-term outcomes in children
Ganesh Shanmugam1, Kenneth MacArthur, James Pollock
1Department of Cardiac Surgery, Royal Hospital for Sick Children, Glasgow, UK.
The Journal of Heart Valve Disease
|March 29, 2005
Summary
Mechanical aortic valve replacement in children shows excellent long-term outcomes. This procedure offers low mortality and infrequent complications, making it a highly effective treatment option for pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomaterials in Medicine
Background:
- Mechanical aortic valve replacement (AVR) is a critical intervention for pediatric heart conditions.
- Understanding long-term outcomes is essential for optimizing patient care and surgical strategies.
Purpose of the Study:
- To analyze the early and late outcomes of mechanical AVR in pediatric patients.
- To evaluate survival rates, reintervention needs, and complication frequencies.
Main Methods:
- A retrospective analysis of 55 children undergoing mechanical AVR between 1980 and 2003.
- Inclusion of patients with aortic regurgitation, stenosis, or mixed disease, with detailed reporting of surgical procedures and follow-up.
- Data collection on survival, reoperations, thromboembolism, bleeding, and prosthetic valve endocarditis (PVE).
Main Results:
- Actuarial survival at 20 years was 98%.
- Event-free survival at 20 years was 88%, with freedom from reintervention at 92%.
- Low linearized rates for bleeding (0.15%/pt-yr) and PVE (0.3%/pt-yr); no thromboembolism or structural valve dysfunction reported.
Conclusions:
- Mechanical AVR, including aortic root enlargement when needed, is a safe and effective treatment for children.
- The procedure is associated with low mortality and morbidity, with infrequent late embolic and hemorrhagic complications.