Valve surgery in children

Valve surgery constitutes a small percentage of overall pediatric cardiac practice. Most of the lesions seen are congenital anomalies, often in association with other lesions. Valvotomy and valvuloplasty can usually provide good long term palliation, although reoperation is probably inevitable. The late results of valve replacement in children have been compromised by the rapid calcification of biologic valves. There is some evidence to suggest that this may not occur with homograft valves. The importance of implanting as large a valve as possible is emphasized and follow-up must include an assessment of whether the child is outgrowing the previously implanted prosthesis.