Replacement of cardiac valves in children

Klint, Robert; Hernandez, Antonio; Weldon, Clarence S.; Hartmann, Alexis F.; Goldring, David

doi:10.1016/s0022-3476(72)80011-8

Cited by 35 publications

(1 citation statement)

References 30 publications

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“…They also recorded a 4% incidence of prosthetic valve endocarditis. Further, it is established that thromboembolic events can occur despite apparently adequate anticoagulant therapy [7,10]. On the benefit side, anticoagulant therapy does reduce the early mortality rate.…”

Section: Choice Of Valvementioning

confidence: 99%

Valve replacement in children

Elliott

Leval

1985

World j. surg.

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With increasing experience in the surgical management of children with congenital heart disease has come an increasing use of prosthetic valves. They have been employed in a wide variety of conditions ranging from simple congenital stenosis or incompetence to an essential part of repair of more complex disorders. As in adult cardiac surgery, there has been considerable debate over the exact prostheses that should be used in individual circumstances. As we point out in this article, experience has varied both geographically and with time. Our own experience at Great Ormond Street, for example, has been of initial satisfaction with results of mechanical valves followed by enthusiasm for, sequentially, the Hancock and the Ionescu prostheses. Now we have turned full circle and predominantly use mechanical valves, primarily owing to the extraordinary incidence of premature, degenerative calcification of bioprosthetic valves in children. The exact rates of degeneration of these valves are variable; thus it is difficult to relate prosthesis survival to the growth rate of the child. The experience with homograft valve replacements is encouraging, since they do not seem to degenerate so rapidly. Valve replacement in children carries a high risk. The younger the child, the higher the risk, with mitral valve replacement being the most dangerous procedure of all. We conclude that valve replacement in children is a procedure that should not be taken lightly and for which, at present, mechanical valves offer the best prognosis, despite the small risk of anticoagulation.

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Section: Choice Of Valvementioning

confidence: 99%