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[Aortic valve replacement in children]

E Saro-Servando1, S Vobecky, C Chartrand

  • 1Service de Chirurgie Cardiovasculaire, Hôpital Sainte-Justine, Côte Sainte-Catherine, Montréal, Québec, Canada.

Annales De Chirurgie
|January 1, 1994
PubMed
Summary
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Pediatric aortic valve replacement shows excellent outcomes for isolated procedures. However, combining valve replacement with major cardiac surgery significantly increases hospital mortality risks in children.

Area of Science:

  • Pediatric Cardiac Surgery
  • Valvular Heart Disease Management
  • Biomedical Engineering (Prosthetic Valves)

Context:

  • Aortic valve replacement (AVR) in children presents unique challenges due to congenital defects and prior interventions.
  • From 1970-1993, 47 pediatric AVRs were analyzed, with 39 cases of congenital valvular pathology.
  • Many patients had associated cardiac anomalies or previous aortic outflow surgeries.

Purpose:

  • To evaluate the outcomes of aortic valve replacement in pediatric patients.
  • To compare results of isolated AVR versus AVR combined with major cardiac procedures.
  • To assess the long-term durability and complications of different prosthetic valve types in children.

Summary:

  • 47 children underwent AVR (1970-1993); 7 bioprostheses and 40 mechanical valves were used.

Related Experiment Videos

  • Isolated AVR had no hospital deaths, while combined procedures with major cardiac surgery had a 41% mortality rate (7/17).
  • Late outcomes included 3 deaths, 3 reoperations (2 for bioprosthetic degeneration), 1 thromboembolic event, and 1 hemolytic anemia episode.

    • Impact:

    • Isolated AVR in children yields excellent results, with low morbidity and mortality.
    • Combined AVR and major cardiac procedures carry substantial hospital mortality risk.
    • Bioprosthetic valves are contraindicated in children due to rapid degeneration; mechanical valves are preferred.