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. 1999 Aug;68(2):521-5; discussion 525-6.
doi: 10.1016/s0003-4975(99)00642-6.

Intermediate-term results in pediatric aortic valve replacement

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Intermediate-term results in pediatric aortic valve replacement

F M Lupinetti et al. Ann Thorac Surg. 1999 Aug.

Abstract

Background: Aortic valve replacement (AVR) in children is now more commonly performed with human tissue valves.

Methods: The results of 100 consecutive pediatric AVRs (50 mechanical, 50 human) were reviewed.

Results: There were five perioperative deaths in the mechanical group and one in the human group (p = 0.2). Late complications in the mechanical group included 4 late deaths, 2 cases of endocarditis, 3 thromboembolic complications, and 10 reoperations on the aortic valve. In the human group, there were no late deaths, 2 reoperations for allograft aortic valve deterioration (both in Marfan's patients), and 1 reoperation for allograft pulmonary valve stenosis. Four-year actuarial survival was 83% in the mechanical group and 98% in the human group (p = 0.02). Four-year actuarial survival free of all valve-related complications was 61% in the mechanical group and 88% in the human group (p = 0.008).

Conclusions: Human valves in children requiring AVR provide superior intermediate-term survival and freedom from valve-related complications compared to mechanical valves. Marfan's syndrome may represent a rare remaining contraindication for human AVR in children.

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