Related Experiment Video
Updated: May 29, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
[Long-term outcome of aortic valve replacement with annular enlargement]
Yoshiyuki Maekawa1, Takahiko Sakamoto, Kentaro Umezu
1Division of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
Background:
The choice of appropriate treatment in children with aortic valvular lesions remains controversial. The purpose of this study is to assess early and late outcomes of aortic valve replacement with annular enlargement in children.
Methods:
A retrospective study was conducted in 16 consecutive patients aged 0.26 to 15.9 years operated on between 1993 and 2008. Thirteen children underwent aortic valve replacement with Konno procedure (mechanical valve: 12, homograft: 1), 2 children underwent Ross procedure, and the last child underwent Nicks procedure with mechanical valve replacement. All patients undergoing mechanical valve replacement were given warfarin with a monthly international normalized ratio (INR) control.
Results:
Overall early mortality was 12.5% (2 cases). Emergency operation was performed in these cases because of infectious endocarditis and acute cardiac failure. However, cardiopulmonary bypass (CPB) weaning could not be obtained. There was 1 late death 5 months after mechanical valve replacement. The patient developed methicillin-resistant Staphylococcus aureus (MRSA) sepsis after cleft palate repair. Reoperation was needed in 1 case.
Conclusion:
We conclude that mechanical valve replacement with aortic annular enlargement is an acceptable treatment in children. It is associated with acceptable mortality and low incidence of late events, and provides long-term survival.
Related Concept Videos
Aortic Regurgitation III: Medical Management
Aortic Regurgitation I: Introduction
Aneurysm III: Interprofessional Care
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Regurgitation I: Introduction
Aneurysm I: Introduction
