Mechanical Valve Replacement in Children and the Result of Mid-long Term Follow-up_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUhao ,  MEIJu , TANGMin , YINhang , ZhANGYun-jiao , YANGQi , WUShu-bin

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200082, P. R. China;

Corresponding author：

MEIJu, Email: ju_mei63@126.com

Keywords：

Valve replacement; Children; Anticoagulant therapy; Therapeutic effect

DOI：

10.7507/1007-4848.20150117

Video：

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Objective To summarize the clinical characteristics and mid-long term efficacy of children under 15 years with mechanical valve replacement. Methods We retrospectively analyzed the clinical data of 51 children aged 1 to 15 years underwent mechanical valve replacement in Xinhua Hospital between January 2006 and January 2014. There were 32 males and 19 females with mean age of 9.6±4.0 years (ranged 1-15 years). Results The average cardiopulmonary bypass time was 120.50±61.02 minutes, and average aortic cross-clamping time was 68.35±42.68 minutes. One patient died in hospital. There were 6 patients (11.8%) with complications including mitral paravalvular leakage in 1 patient, malignant ventricular arrhythmia in 1 patient, respiratory failure in 1 patient, acute renal failure in 2 patients, and delayed thoracic close in 1 patient. All the children cured and were followed up for 1-96 months. One patient died during the follow-up time. No other redo-valve replacement or complications correlated to anticoagulant occurred. Conclusions Mechanical valve replacement may be necessary in children with extremely dysplastic valves and severe hemodynamic impairment or after failed repair. With appropriate selection of the prosthetic valve and intensive care therapy during the peroperative period, the mid to long term efficacy is optimistic.

Citation： LIUhao, MEIJu, TANGMin, YINhang, ZhANGYun-jiao, YANGQi, WUShu-bin. Mechanical Valve Replacement in Children and the Result of Mid-long Term Follow-up. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(5): 446-449. doi: 10.7507/1007-4848.20150117 Copy

1.	Popov AF, Coskun KO, Tirilomis T, et al. Mechanical aortic valve replacement in children and adolescents after previous repair of congenital heart disease. Artif Organs, 2009, 33(11):915-921.
2.	Panda BR, Shank ar R, Kuruvilla KT, et al. Combined mitral and aortic valve replacement for rheumatic heart disease:Fifeen-year follow up and long-term results. J Heart Valve Dis, 2009, 18(2):170-179.
3.	Rafi DY, Davies RR, Carroll SJ, et al. Age less than two years is not a risk factor for mortality afer mitral valve replacement in children. Ann Torac Surg, 2011, 91(4):1228-1234.
4.	Arnold R, Ley-Zaporozhan J, Ley S, et al. Outcome afer mechanical aortic valve replacement in children and young adults. Ann Torac Surg, 2008, 85(2):604-610.
5.	Losenno KL, Gelinas JJ, Johnson M, et al. Defining the efficacy of aortic root enlargement procedures:a comparative analysis of surgical techniques. Can J Cardiol, 2013, 29(4):434-440.
6.	Ackermann K, Balling G, Eicken A, et al. Replacement of the systemic atrioventricular valve with a mechanical prosthesis in children aged less than 6 years:Late clinical results of survival and subsequent replacement. J Thorac Cardiovasc Surg, 2007, 134(3):750-756.
7.	David TE. Reoperations after Ross Procedure. Circulation, 2010, 122:1139-1140.
8.	Raghuveer G, Caldarone CA, Hills CB, et al. Predictors of prosthesis survival, growth, and functional status following mechanical mitral valve replacement in children aged < 5 years, a multi-institutional study. Circulation, 2003, 108(suppl 1):Ⅱ174-Ⅱ179.
9.	Kojori F, Chen R, Caldarone CA, et al. Outcomes of mitral valve replacement in children:a competing-risks analysis. J Thorac Cardiovasc Surg, 2004, 128(5):703-709.
10.	Henaine R, Nloga J, Wautot F, et al. Long-term outcome after annular mechanical mitral valve replacement in children aged less than fve years. Ann Torac Surg, 2010, 90(5):1570-1576.
11.	Caldarone CA, Raghuveer G, Hills CB, et al. Long-term survival afer mitral valve replacement in children aged < 5 years:a multiinstitutional study. Circulation, 2001, 104(12 Suppl 1):I143-I147.
12.	Alsoufi B. Aortic valve replacement in children:Options and outcomes. J Saudi Heart Assoc, 2014, 26(1):33-41.
13.	Miceli A, Duggan SM, Capoun R, et al. A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafing. Ann Torac Surg, 2010, 90(2):522-526.
14.	Ranucci M, Ballotta A, Castelvecchio S, et al. Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion. Acta Anaesthesiol Scand, 2010, 54(7):878-884.
15.	Bonios MJ, Pierrakos CN, Argiriou M, et al. Increase in coronary blood flow by intra-aortic balloon counterpulsation in a porcine model of myocardial reperfusion. Int J Cardiol, 2010, 138(3):253-260.
16.	刘浩, 丁芳宝, 黄健兵, 等.主动脉内球囊反搏在主动脉瓣轻、轻中度反流患者中的应用.中国胸心血管外科临床杂志, 2012, 19(1):48-51.
17.	肖荣冬, 翁国星, 谢维泉, 等.感染性心内膜炎的围术期治疗和危险因素分析.中国胸心血管外科临床杂志, 2014, 21(1):128-131.
18.	Alexiou C, Galogavrou M, Chen Q, et al. Mitral valve replacement with mechanical prostheses in children:improved operative risk and survival. Eur J Cardiothorac Surg, 2001, 20(1):105-113.
19.	Alexiou C, McDonald A, Langley SM, et al. Aortic valve replacement in children:are mechanical prostheses a good option? Eur J Cardiothorac Surg, 2000, 17(2):125-133.
20.	Mokhles MM, Körtke H, Stierle U, et al. Survival comparison of the Ross procedure and mechanical valve replacement with optimal self-management anticoagulation therapy:propensity-matched cohort study. Circulation, 2011, 123(1):31-38.

1. Popov AF, Coskun KO, Tirilomis T, et al. Mechanical aortic valve replacement in children and adolescents after previous repair of congenital heart disease. Artif Organs, 2009, 33(11):915-921.
2. Panda BR, Shank ar R, Kuruvilla KT, et al. Combined mitral and aortic valve replacement for rheumatic heart disease:Fifeen-year follow up and long-term results. J Heart Valve Dis, 2009, 18(2):170-179.
3. Rafi DY, Davies RR, Carroll SJ, et al. Age less than two years is not a risk factor for mortality afer mitral valve replacement in children. Ann Torac Surg, 2011, 91(4):1228-1234.
4. Arnold R, Ley-Zaporozhan J, Ley S, et al. Outcome afer mechanical aortic valve replacement in children and young adults. Ann Torac Surg, 2008, 85(2):604-610.
5. Losenno KL, Gelinas JJ, Johnson M, et al. Defining the efficacy of aortic root enlargement procedures:a comparative analysis of surgical techniques. Can J Cardiol, 2013, 29(4):434-440.
6. Ackermann K, Balling G, Eicken A, et al. Replacement of the systemic atrioventricular valve with a mechanical prosthesis in children aged less than 6 years:Late clinical results of survival and subsequent replacement. J Thorac Cardiovasc Surg, 2007, 134(3):750-756.
7. David TE. Reoperations after Ross Procedure. Circulation, 2010, 122:1139-1140.
8. Raghuveer G, Caldarone CA, Hills CB, et al. Predictors of prosthesis survival, growth, and functional status following mechanical mitral valve replacement in children aged < 5 years, a multi-institutional study. Circulation, 2003, 108(suppl 1):Ⅱ174-Ⅱ179.
9. Kojori F, Chen R, Caldarone CA, et al. Outcomes of mitral valve replacement in children:a competing-risks analysis. J Thorac Cardiovasc Surg, 2004, 128(5):703-709.
10. Henaine R, Nloga J, Wautot F, et al. Long-term outcome after annular mechanical mitral valve replacement in children aged less than fve years. Ann Torac Surg, 2010, 90(5):1570-1576.
11. Caldarone CA, Raghuveer G, Hills CB, et al. Long-term survival afer mitral valve replacement in children aged < 5 years:a multiinstitutional study. Circulation, 2001, 104(12 Suppl 1):I143-I147.
12. Alsoufi B. Aortic valve replacement in children:Options and outcomes. J Saudi Heart Assoc, 2014, 26(1):33-41.
13. Miceli A, Duggan SM, Capoun R, et al. A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafing. Ann Torac Surg, 2010, 90(2):522-526.
14. Ranucci M, Ballotta A, Castelvecchio S, et al. Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion. Acta Anaesthesiol Scand, 2010, 54(7):878-884.
15. Bonios MJ, Pierrakos CN, Argiriou M, et al. Increase in coronary blood flow by intra-aortic balloon counterpulsation in a porcine model of myocardial reperfusion. Int J Cardiol, 2010, 138(3):253-260.
16. 刘浩, 丁芳宝, 黄健兵, 等.主动脉内球囊反搏在主动脉瓣轻、轻中度反流患者中的应用.中国胸心血管外科临床杂志, 2012, 19(1):48-51.
17. 肖荣冬, 翁国星, 谢维泉, 等.感染性心内膜炎的围术期治疗和危险因素分析.中国胸心血管外科临床杂志, 2014, 21(1):128-131.
18. Alexiou C, Galogavrou M, Chen Q, et al. Mitral valve replacement with mechanical prostheses in children:improved operative risk and survival. Eur J Cardiothorac Surg, 2001, 20(1):105-113.
19. Alexiou C, McDonald A, Langley SM, et al. Aortic valve replacement in children:are mechanical prostheses a good option? Eur J Cardiothorac Surg, 2000, 17(2):125-133.
20. Mokhles MM, Körtke H, Stierle U, et al. Survival comparison of the Ross procedure and mechanical valve replacement with optimal self-management anticoagulation therapy:propensity-matched cohort study. Circulation, 2011, 123(1):31-38.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Mechanical Valve Replacement in Children and the Result of Mid-long Term Follow-up

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