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Long-Term Outcomes of Mechanical Aortic Valve Replacement in Children.
Zhu, Michael Z L; Buratto, Edward; Wu, Damien M; Ishigami, Shuta; Schulz, Antonia; Brizard, Christian P; Konstantinov, Igor E.
Afiliación
  • Zhu MZL; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Australia.; Heart Research Group Murdoch Children's Research Institute, Melbourne, Australia.
  • Buratto E; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Australia.; Heart Research Group Murdoch Children's Research Institute, Melbourne, Australia.
  • Wu DM; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Australia.; Heart Research Group Murdoch Children's Research Institute, Melbourne, Australia.
  • Ishigami S; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
  • Schulz A; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
  • Brizard CP; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Australia.; Heart Research Group Murdoch Children's Research Institute, Melbourne, Australia.; Melbourne Children's Centre for Cardiovascular Genomics and R
  • Konstantinov IE; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.; Department of Paediatrics, University of Melbourne, Melbourne, Australia.; Heart Research Group Murdoch Children's Research Institute, Melbourne, Australia.; Melbourne Children's Centre for Cardiovascular Genomics and R
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu ; 27: 52-60, 2024.
Article en En | MEDLINE | ID: mdl-38522873
ABSTRACT
When the options of aortic valve repair or the Ross procedure are not feasible or have been exhausted, mechanical aortic valve replacement (AVR) may provide a reliable and structurally durable alternative, but with the limitations of long-term anticoagulation, thrombosis risk and lack of valve growth potential. In this article, we review the longitudinal outcomes of mechanical AVR in children in our institution and compare them to those recently reported by others. From 1978 to 2020, 62 patients underwent mechanical AVR at a median age of 12.4 years (interquartile range (IQR) 8.6-16.8 years). The most common underlying diagnoses were conotruncal anomalies (40%, 25/62), congenital aortic stenosis (16%, 10/62), rheumatic valve disease (16%, 10/62), connective tissue disease (8.1%, 5/62) and infective endocarditis (6.5%, 4/62). Thirty-two patients (52%, 32/62) had at least 1 prior aortic valve surgery prior to mechanical AVR. Early death was 3.2% (2/62). Median follow-up was 14.4 years (IQR 8.4-28.2 years). Kaplan-Meier survival was 96.8%, 91.9%, 86.3%, and 81.9% at 1, 5, 10, and 20 years. On competing risk analysis, the proportion of patients alive without aortic valve reoperation at 1, 5, 10, and 20 years was 95.2%, 87.0%, 75.5% and 55.4%, respectively, while the proportion of patients that had aortic valve reoperation (with death as a competing event) at 1, 5, 10, and 20 years was 1.6%, 4.9%, 12.8%, and 28.5%, respectively. In conclusion, when the options of aortic valve repair or the Ross procedure are not feasible in children, mechanical AVR is an alternative, yet the long-term rates of mortality and need for aortic valve reoperation are of concern.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis Valvulares Cardíacas / Implantación de Prótesis de Válvulas Cardíacas / Enfermedades de las Válvulas Cardíacas Límite: Child / Humans Idioma: En Revista: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis Valvulares Cardíacas / Implantación de Prótesis de Válvulas Cardíacas / Enfermedades de las Válvulas Cardíacas Límite: Child / Humans Idioma: En Revista: Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos