Valve replacement in pediatric patients: a single center experience

Area of Science:

• Pediatric Cardiology
• Cardiac Surgery
• Biomaterials Science

Background:

• Reconstructive surgery is preferred for pediatric valve disease.
• Valve replacement is necessary for irreparable lesions.
• This study analyzes pediatric mechanical valve replacement outcomes.

Purpose of the Study:

• To retrospectively analyze the clinical experience of heart valve prosthesis replacement in children.
• To evaluate the safety and efficacy of mechanical valve replacement in a pediatric population.
• To assess long-term outcomes and complications associated with mechanical heart valves in children.

Main Methods:

• Retrospective analysis of 35 pediatric patients (ages 2.5-14) undergoing mechanical valve replacement (1990-2009).
• St. Jude bileaflet mechanical valves implanted for congenital, rheumatic, or infective endocarditis-related heart disease.
• All patients received long-term warfarin anticoagulation (INR 1.5-2.0).

Main Results:

• Operative mortality was 8.57% (3/35), with deaths due to low cardiac output, cardiogenic shock, and renal failure.
• 32 patients survived with improved New York Heart Association (NYHA) class I-II function post-discharge.
• Late events included hemorrhage and endocarditis; two patients required reoperation. No late deaths occurred.

Conclusions:

• Mechanical valve replacement is an acceptable treatment for pediatric patients with irreparable valve disease.
• Operative mortality and valve-related events are within acceptable ranges.
• This procedure offers a viable solution when valve repair is not feasible.