open access

Vol 65, No 6 (2007)
Other
Published online: 2007-07-02
Submitted: 2012-12-28
Get Citation

Original article
Evolving approach to aortic valve replacement in children and adolescents – a preliminary report

Piotr Burczyński, Krzysztof Mozol, Małgorzata Mirkowicz-Małek, Ireneusz Haponiuk, Andrzej Kansy, Wojciech Lipiński, Mariusz Birbach, Andrzej Pastuszko, Michał Kozłowski, Bohdan Maruszewski
Kardiol Pol 2007;65(6):654-661.

open access

Vol 65, No 6 (2007)
Other
Published online: 2007-07-02
Submitted: 2012-12-28

Abstract

Background: Surgical treatment methods are still controversial in children with congenital or acquired aortic valve dysfunction. Aim: To evaluate treatment results in children after mechanical or biological valve implantation. Methods: We analysed a group of 55 children after mechanical valve implantation (group A) and a group of 8 children after Freestyle biological valve implantation (group B). We evaluated in both groups: patient’s age, type of valve dysfunctions, severity of heart failure symptoms, and quality of life. The parameters of physiological left ventricular (LV) remodelling were examined on the basis of echocardiographical signs of LV contractibility (%SF) and anatomical changes: LV diastolic diameter (LVDd), LV posterior wall thickness (LVPW), thickness of intra-ventricle septum (IVS) and pressure gradient between LV and aorta (LV-Ao). Results: There were no hospital deaths in either group. There were two late deaths in children from group A. Thromboembolic (2), nonspecific bleeding complications (2), and infections (2) occurred in group A. There were two re-operations in children after mechanical valve implantation. The early postoperative period was good in groups A and B. Furthermore, late postoperative period was good in group B. Physiological LV remodelling occurred in children in groups A and B. Quality of life was good in both groups. Conclusions: Good clinical results, simplicity, repeatability and safety of surgical technique mean that mechanical valve implantation in the aortic position is still an attractive option for treatment in children and adults. However, absence of bleeding, thromboembolic and infection complications and improvement of durability mean that the Freestyle biological new generation valve could be a good option for future in children and adolescents who need aortic valve replacement.

Abstract

Background: Surgical treatment methods are still controversial in children with congenital or acquired aortic valve dysfunction. Aim: To evaluate treatment results in children after mechanical or biological valve implantation. Methods: We analysed a group of 55 children after mechanical valve implantation (group A) and a group of 8 children after Freestyle biological valve implantation (group B). We evaluated in both groups: patient’s age, type of valve dysfunctions, severity of heart failure symptoms, and quality of life. The parameters of physiological left ventricular (LV) remodelling were examined on the basis of echocardiographical signs of LV contractibility (%SF) and anatomical changes: LV diastolic diameter (LVDd), LV posterior wall thickness (LVPW), thickness of intra-ventricle septum (IVS) and pressure gradient between LV and aorta (LV-Ao). Results: There were no hospital deaths in either group. There were two late deaths in children from group A. Thromboembolic (2), nonspecific bleeding complications (2), and infections (2) occurred in group A. There were two re-operations in children after mechanical valve implantation. The early postoperative period was good in groups A and B. Furthermore, late postoperative period was good in group B. Physiological LV remodelling occurred in children in groups A and B. Quality of life was good in both groups. Conclusions: Good clinical results, simplicity, repeatability and safety of surgical technique mean that mechanical valve implantation in the aortic position is still an attractive option for treatment in children and adults. However, absence of bleeding, thromboembolic and infection complications and improvement of durability mean that the Freestyle biological new generation valve could be a good option for future in children and adolescents who need aortic valve replacement.
Get Citation

Keywords

aortic valve dysfunction; mechanical prosthesis; stentless biological prosthesis; children

About this article
Title

Original article
Evolving approach to aortic valve replacement in children and adolescents – a preliminary report

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 6 (2007)

Pages

654-661

Published online

2007-07-02

Bibliographic record

Kardiol Pol 2007;65(6):654-661.

Keywords

aortic valve dysfunction
mechanical prosthesis
stentless biological prosthesis
children

Authors

Piotr Burczyński
Krzysztof Mozol
Małgorzata Mirkowicz-Małek
Ireneusz Haponiuk
Andrzej Kansy
Wojciech Lipiński
Mariusz Birbach
Andrzej Pastuszko
Michał Kozłowski
Bohdan Maruszewski

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl