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Cardiac valve prostheses in children without anticoagulation.
The Journal of Thoracic and Cardiovascular Surgery
|June 1, 1984
Summary
The St. Jude Medical cardiac valve prosthesis shows no thromboembolic complications in children without anticoagulation. This investigational use suggests a comparable risk to anticoagulated adults, warranting further study.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
Background:
- Cardiac valve replacement in children often requires lifelong anticoagulation.
- The St. Jude Medical mechanical valve has been used in adults with varying anticoagulation strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of the St. Jude Medical cardiac valve prosthesis in pediatric patients without postoperative anticoagulation.
- To assess the incidence of thromboembolic complications in this specific patient group.
Main Methods:
- Retrospective analysis of 34 children (9 months to 21 years) who received St. Jude Medical valves between March 1979 and follow-up.
- Valves were implanted in mitral, aortic, pulmonary, and tricuspid positions, including complex cases.
- Follow-up duration ranged from 1 to 50 months (646 patient-months).
Main Results:
- Three operative deaths occurred, primarily in infants with complex congenital heart disease.
- One late death occurred 5 weeks post-surgery, likely due to arrhythmia.
- No thromboembolic complications were observed during the follow-up period.
Conclusions:
- Preliminary data suggest that the St. Jude Medical prosthesis can be used in children without postoperative anticoagulation with a low risk of thromboembolism.
- The observed risk appears comparable to that of anticoagulated adults.
- Further investigation into the use of this prosthesis in pediatric patients without anticoagulation is justified.