Medium-term follow-up of pulmonary autograft replacement of aortic valves in children
| Autor: | Mary M. Lane, Christopher J. Knott-Craig, Kent E. Ward, J. R. Razook, Ronald C. Elkins, Edward D. Overholt, John D. Randolph |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Aortic valve medicine.medical_specialty Adolescent Heart Valve Diseases Ventricular outflow tract obstruction Valvula aortica Medium term Internal medicine medicine Humans Pulmonary root Child Retrospective Studies Pulmonary Valve business.industry Incidence (epidemiology) Infant General Medicine Surgery medicine.anatomical_structure Aortic Valve Child Preschool Pulmonary valve Cardiology Female Implant medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 8:379-383 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/1010-7940(94)90032-9 |
| Popis: | Pulmonary autograft replacement (PAG) of the aortic valve in children has been shown to be safe and effective with a low incidence of late valve dysfunction. Relief of all types of left ventricular outflow tract obstruction using the pulmonary root has been possible. Concern about the durability of the pulmonary root in the aortic position, and the potential for growth of the pulmonary autograft used either as a root replacement or intraaortic implant, has been questioned. Sixty-five consecutive patients, aged 1.8 to 21 years (mean 12 years) operated on between September 1986 and January 1993, 35 with an intra-aortic implant (IA) and 30 with root replacement (RR), were evaluated by clinical and serial echocardiographic studies (ECHO) up to 6.5 years post-operatively. The hospital mortality rate was 3.0% (70% CL 2.1-5.1%). Two patients required reoperation for PAG insufficiency (AI), one for technical malalignment necessitating replacement at 6 months, and one with progressive leaflet prolapse due to adherence of the valve leaflet to a ventricular septal defect (VSD) patch. Freedom from significant aortic regurgitation at 6-year follow-up was 100% for RR and 91 +/- 6% for IA, and freedom from all valve-related complications including reoperation was 92 +/- 5% at 6 years. Significant enlargement of the aortic annulus which parallels somatic growth has been measured by ECHO in 17 IA implants (P0.001) and 17 RR patients (P0.01) by 1 year, and in 10 IA (P = 0.007) and 6 RR (P0.05) by 2 years.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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