Pulmonary autograft replacement in children. The ideal solution?
| Autor: | Kent E. Ward, Christopher J. Knott-Craig, Kathylee Santangelo, Ronald C. Elkins, Webb M. Thompson, Edward D. Overholt, Paul Stelzer, Jerry D. Razook, John D. Randolph |
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| Rok vydání: | 1992 |
| Předmět: |
Aortic valve
Adult Male Reoperation medicine.medical_specialty Adolescent Hemodynamics Pulmonary Artery Transplantation Autologous Ventricular Function Left Postoperative Complications Aortic valve replacement Internal medicine Medicine Humans Mass index LV hypertrophy Child business.industry Infant medicine.disease Echocardiography Doppler Surgery Stenosis medicine.anatomical_structure Treatment Outcome El Niño Echocardiography Aortic Valve Child Preschool Operative death Cardiology Female business Research Article |
| Zdroj: | Annals of surgery. 216(3) |
| ISSN: | 0003-4932 |
| Popis: | Fifty-one children, aged 1.8 to 21 years (mean, 11.4) with aortic valve replacement using a pulmonary autograft are reviewed. Twenty-nine were intra-aortic implants and 22 were root replacements. There was one operative death, no late deaths, and two have required reoperation. Actuarial freedom from reoperation was 93% +/- 5.5 at 5.6 years. Freedom from progression of aortic insufficiency (AI) was 81% +/- 9 at 5.6 years in the intra-aortic implants and 86% +/- 10 in the root replacement. Enlargement of the pulmonary autograft was seen echocardiographically in both groups. This enlargement was consistent with somatic growth and not associated with progression of AI. Ten of 19 patients with aortic stenosis had an LV mass index suggestive of LV hypertrophy before operation. At 1 year, 18 of 25 had a normal LV mass index. Thirteen of 16 patients with AI had preoperative abnormal LV mass index. All but four returned to normal by 1 year. Low operative risk, excellent function, resolution of abnormal LV hemodynamics, and enlargement consistent with somatic growth suggest that the pulmonary autograft is the ideal replacement for the malfunctioning aortic valve. |
| Databáze: | OpenAIRE |
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