Aortic valve replacement in preteenage children

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Biomaterials in Medicine

Background:

• Aortic valve disease in children often stems from congenital heart defects.
• Previous cardiac surgeries are common in pediatric patients requiring aortic valve replacement.
• Marfan syndrome and rheumatic heart disease are other indications for aortic valve replacement in pediatric populations.

Purpose of the Study:

• To evaluate the safety and long-term efficacy of subcoronary aortic valve replacement (AVR) in pediatric patients.
• To assess the outcomes of AVR in children with congenital heart disease and other etiologies.
• To analyze the performance of various prosthetic valves used in pediatric AVR.

Main Methods:

• Retrospective review of 26 pediatric patients (4-12 years) who underwent subcoronary AVR over 15 years.
• Analysis of patient demographics, underlying cardiac conditions, surgical procedures, and prosthetic valve types.
• Long-term follow-up data collection for survival rates, functional status, and complications.

Main Results:

• An early mortality rate of 3.8% (1 of 26 patients) was observed.
• Late mortality occurred in 11.5% (3 of 20 patients) with available follow-up data (1 month to 10 years).
• Survivors demonstrated good exercise tolerance, indicating successful long-term outcomes.

Conclusions:

• Pediatric aortic valve replacement is a safe and durable therapeutic option.
• Subsequent AVR procedures in adulthood can accommodate larger prostheses.
• The Ionescu-Shiley bovine xenograft is currently favored due to excellent hemodynamics and low embolic risk.