Pulmonary Autograft Replacement in Children The Ideal Solution?
- 1 September 1992
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 216 (3), 363-371
- https://doi.org/10.1097/00000658-199209000-00016
Abstract
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 cchocardiographically 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.Keywords
This publication has 29 references indexed in Scilit:
- Prosthetic heart valve replacement in children. Results and follow-up of 273 patients.1987
- Valve replacement in children less than 5 years of ageJournal of the American College of Cardiology, 1986
- Aortoventriculoplasty in childrenThe Journal of Thoracic and Cardiovascular Surgery, 1986
- Late results after left-sided cardiac valve replacement in childrenThe Journal of Thoracic and Cardiovascular Surgery, 1986
- Long-term Assessment of Aortic Valve Replacement with Autologous Pulmonary ValveThe Annals of Thoracic Surgery, 1985
- Prosthetic valve replacement in infants and children.1984
- Late results after Starr-Edwards valve replacement in childrenThe Journal of Thoracic and Cardiovascular Surgery, 1984
- Ten Years' Experience with Pulmonary Autograft Replacements for Aortic Valve DiseaseThe Annals of Thoracic Surgery, 1979
- REPLACEMENT OF AORTIC AND MITRAL VALVES WITH A PULMONARY AUTOGRAFTThe Lancet, 1967
- A method for preparing and inserting a homograft aortic valveBritish Journal of Surgery, 1965