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Prosthetic valve replacement in infants and children
Insights
Pediatric valve replacement surgery, including mitral and aortic valves, showed a low mortality rate (9.7%) in a 1966-1981 review of 41 children. Long-term outcomes were favorable, with few later deaths or reoperations.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Valve replacement in children presents unique challenges compared to adults.
- Rheumatic and congenital heart defects are primary indications for pediatric valve replacement.
- Historical data on long-term outcomes of pediatric valve replacement is crucial for surgical planning.
Purpose of the Study:
- To review outcomes of valve replacement surgery in pediatric patients.
- To analyze the types of valve deformities and surgical procedures performed.
- To assess hospital mortality, late mortality, and complication rates in children undergoing valve replacement.
Main Methods:
- Retrospective review of 41 pediatric patients (10 months to 16 years) who underwent valve replacement between 1966 and 1981.
- Analysis of valve pathology (rheumatic vs. congenital), type of valve replaced (mitral, aortic, or both), and follow-up data.
- Documentation of hospital mortality, late deaths, reoperations, and thromboembolic events.
Main Results:
- A total of 41 children underwent valve replacement; 61% had rheumatic and 39% congenital deformities.
- Mitral valve replacement was performed in 22 children, aortic in 14, and both in 5.
- Hospital mortality was 9.7%, with only one late death over a mean follow-up of 6.75 years. Three children required a second mitral valve replacement, and 4 experienced thromboembolic episodes.
Conclusions:
- Pediatric valve replacement surgery demonstrated acceptable short-term and long-term outcomes during the study period.
- Rheumatic heart disease was the predominant indication for valve replacement in this pediatric cohort.
- Thromboembolic complications and the need for reoperation highlight ongoing challenges in pediatric cardiac valve surgery.
Abstract:
A review of 41 children from 10 months to 16 years of age who had a valve replacement between the years 1966 to 1981 is reported. Sixty-one per cent of the valve deformities were rheumatic and 39% congenital. Twenty-two children had the mitral valve replaced, 14 had an aortic valve and 5 had both aortic and mitral valve replacement. There was a hospital mortality of 9.7% and only one later death during a mean follow up period of 6.75 years. Three children have required a second mitral valve replacement. Thrombo-embolic episodes were encountered in 4 children. The special problems of valve replacement in infants and children are discussed.