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Valve replacement in children and adolescents
The Journal of Thoracic and Cardiovascular Surgery
|June 1, 1977
Summary
Pediatric heart valve replacement using artificial valves is a serious procedure with a high mortality rate, reserved for cases where other treatments fail. Survival rates have improved recently, but it remains riskier than in adults.
Area of Science:
- Cardiology
- Pediatric Surgery
Background:
- Heart valve replacement is standard for adults but less common in children.
- In pediatric patients, valve replacement is typically a last resort when other interventions are ineffective.
Purpose of the Study:
- To evaluate the outcomes of artificial heart valve replacement in pediatric patients.
- To assess the safety and efficacy of valve replacement in adolescents and older children.
Main Methods:
- A retrospective review of 24 pediatric patients who received 28 artificial heart valves over 10 years.
- Analysis of valve types used (Björk-Shiley for aortic, Beall for mitral) and patient outcomes.
Main Results:
- Sixty-seven percent of patients (16/24) survived the operation and remained symptom-free.
- The overall mortality rate was 33%, with a recent decline to 21% in the last 3 years.
- Rheumatic heart disease was the most common indication (54%), followed by congenital/acquired abnormalities.
Conclusions:
- Pediatric heart valve replacement is a high-risk procedure compared to adults.
- The operation should be reserved for pediatric patients unresponsive to valvuloplasty or valvulotomy.