St. Jude Medical prosthesis in children

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Biomedical Engineering

Background:

• Cardiac valve replacement in children presents unique challenges due to growth and developmental considerations.
• Previous studies on pediatric valve prostheses often had limited follow-up or focused on specific valve types.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of St. Jude Medical prostheses for cardiac valve replacement in pediatric patients.
• To assess the outcomes of anticoagulation with sodium warfarin in children following prosthetic valve implantation.

Main Methods:

• A retrospective review of 20 pediatric patients (ages 2-18) who underwent cardiac valve replacement between December 1980 and April 1992.
• Prostheses included aortic, mitral, and left-sided tricuspid valves; most received adult-sized implants.
• Follow-up was 100% complete, totaling 106 patient-years, with assessment of mortality, thromboembolism, bleeding, endocarditis, and functional class.

Main Results:

• A single hospital death (5%) occurred; no late deaths were observed.
• No instances of thromboembolic events, anticoagulant-related bleeding, prosthetic valve endocarditis, or periprosthetic leaks were reported.
• The majority of survivors (16 of 19) achieved New York Heart Association functional class I status.

Conclusions:

• Cardiac valve replacement with St. Jude Medical prostheses demonstrates excellent long-term results in pediatric patients.
• Sodium warfarin anticoagulation is safe and effective in children after prosthetic valve surgery, with no significant complications.
• The study supports the use of St. Jude Medical prostheses and warfarin therapy for pediatric cardiac valve replacement.