Aortic valve surgery: management and outcomes in the paediatric population

Abstract

Congenital anomalies of the aortic valve frequently necessitate intervention in childhood. The most common aortic valve pathologies present in childhood are aortic stenosis and insufficiency. Presentation of aortic valve disease depends on severity and presence of concomitant syndromes and valvular disorders. Treatment options are largely categorised as medical, percutaneous repair or surgical repair and replacement. Surgical techniques have been refined over the last few years making this the mainstay of treatment in paediatric cases. Whilst repair is considered in most instances before replacement, there are substantial limitations which are reflected in the frequency of reintervention and restenosis rate. Replacements are typically undertaken with tissue or mechanical prosthesis. The current gold-standard aortic valve replacement surgery is called the Ross procedure—where replacement is undertaken with a competent pulmonic valve and a simultaneous pulmonary homograft.Conclusion: In this review, we aim to outline the various surgical options and discuss efficacy and complications of various interventions. What is Known: • Congenital aortic valve defects repair options medically and surgically What is New: • Comparisons between surgical options for aortic valve repair including efficacy, risks and long-term outcomes.

Mechaninio Aortos Vožtuvo Trombozė: Klinikinis Atvejis

“…Chirurginis AV protezavimas arba transkateterinė AV implantacija yra pagrindiniai šios ligos gydymo būdai [2]. Mechaninį protezą rekomenduojama rinktis pacientams, jaunesniems nei 60 metų ir galintiems vartoti antikoaguliantus [3]. Implantavus mechaninį vožtuvą, pacientams kyla didelė insulto ir protezuoto vožtuvo trombozės (PVT) rizika.…”

Prosthetic valve thrombosis: literature review and two case reports

“…Mechanical AV replacement is recommended for patients who are younger than 60 years and have no contraindications to long-term anticoagulation. 13 Mechanical AV prostheses are characterized by their robust structure and a long service life. Monoleafl et valves are composed of a single disc with an opening angle relative to the valve annulus ranging from 60° to 80°, resulting in 2 different sized orifi ces.…”

Mechanical and Structural Adaptation of the Pulmonary Root after Ross Operation in a Murine Model

“…This is due to the early calcification of biological valves in this population [1,2]. Nevertheless, mechanical valves are still a suboptimal choice due to the risk associated with life-long anticoagulation therapy and the lack of growth potential, which predisposes patients to further reoperations [3,4].…”