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Valve replacement in children. A fifteen-year perspective
The Journal of Thoracic and Cardiovascular Surgery
|February 1, 1982
Summary
Pediatric heart valve replacement has become significantly safer, with hospital mortality dropping from 31% to 3% between 1965-1980. Advances in valve prostheses offer better outcomes for children needing aortic, mitral, or tricuspid valve surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Heart valve replacement in children presents unique challenges.
- Historical data on pediatric valve replacement outcomes is crucial for progress.
Purpose of the Study:
- To evaluate the safety and efficacy of pediatric heart valve replacement over a 15-year period.
- To analyze trends in valve prosthesis types and their impact on outcomes.
Main Methods:
- Retrospective review of 64 pediatric patients (ages 1-19) undergoing aortic, mitral, or tricuspid valve replacement.
- Analysis of hospital mortality, thromboembolic complications, and bleeding episodes.
- Comparison of outcomes based on valve prosthesis type and implantation era.
Main Results:
- Hospital mortality decreased significantly from 31% (1965-1970) to 3% (1976-1980).
- Low incidence of thromboembolic complications (0.8% per patient-year) and major bleeding with warfarin.
- Recent use of advanced prostheses like St. Jude Medical valves shows excellent hemodynamic performance.
Conclusions:
- Pediatric heart valve replacement is substantially safer today.
- A wider range of technically satisfactory valve substitutes are now available for children.
- Despite premature tissue valve failure concerns, current options offer improved outcomes.