Related Experiment Videos
[Mitral valve replacement in children with a Björk-Shiley prosthesis]
Insights
Mitral valve replacement in children using the Björk-Shiley prosthesis showed a 79% 5-year survival rate. This procedure offers excellent outcomes for pediatric patients with severe heart conditions when valve repair is not feasible.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Biomaterials Science
Context:
- Mitral valve disease in children presents unique challenges.
- Surgical interventions are critical for improving pediatric cardiac function.
- Limited data exists on long-term outcomes of specific prostheses in pediatric populations.
Purpose:
- To document the experience and outcomes of mitral valve replacement in pediatric patients.
- To evaluate the efficacy and safety of the Björk-Shiley prosthesis in children.
- To assess functional capacity and survival rates post-operation.
Summary:
- 30 pediatric patients (<15 years) underwent mitral valve replacement (1978-1982) for rheumatic (90%) or congenital (10%) heart disease.
- Preoperative functional capacity was significantly impaired (NYHA Class II-IV).
- Early mortality was 3.3%, with a 5-year actuarial survival of 79%. Postoperative functional class improved significantly (NYHA Class I-II).
Impact:
- The Björk-Shiley prosthesis demonstrates favorable long-term results in pediatric mitral valve replacement.
- This study provides valuable data for surgical decision-making in complex pediatric cardiac cases.
- Improved functional capacity and survival rates highlight the benefits of timely intervention.
Abstract:
This report documents our experience with mitral valve replacement in children. Between 1978 and 1982, 30 replacements have been performed in patients under 15 years of age. Twenty seven patients (90%) with rheumatic heart disease and 3 (10%) had congenital disease. Their functional capacity prior to operation was as follows: Nine patients fell into class II, 18 into class III and 2 into class IV. Preoperative cardiac catheterization, was undertaken in 26 patients, the mean pulmonary arterial wedge pressure was 27.4 +/- 8 mmHg, the pulmonary artery mean pressure was 48 +/- 20 mmHg, the left ventricular end diastolic pressure was 11.7 +/- 5.6 mmHg. One child died in the operative period. Twenty six patients (90%) have been followed for a mean period of 22.7 months. Late mortality occurred in three patients (11%). Bacterial endocarditis, thromboembolism and valve maldisfunction were not present. The post operative NYHA functional class was as follows: twenty two children fell into class I, and one patient fell into class II. The actuarial survival rate 5 years after operation was 79%. We believe that the Björk-Shiley prosthesis offer excellent results in children when repair of the natural valve is not possible.