Multicentre comparative analysis of long-term outcomes after aortic valve replacement in children

Knight, Jessica; Sarvestani, Amber Leila; Ibezim, Chizitam F; Turk, Elizabeth; Alsoufi, Bahaaldin; Louis, James St.; Moller, James H.; Raghuveer, Geetha; Kochilas, Lazaros

doi:10.1136/heartjnl-2021-319597

Cited by 4 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A significant number of recent studies have shown that the Ross procedure boasts excellent overall transplant-free survival, aortic valve reoperation-free survival, and event-free survival [ 9 - 11 ]. Moreover, some reports have highlighted the superiority of the Ross procedure in terms of survival and freedom from reoperation or event, compared to mechanical AVR in children and young adults [ 12 - 14 ]. However, the Ross procedure is technically challenging, carries a long-term risk of autograft dilatation and subsequent failure, and has a high likelihood of necessitating reoperation or reintervention in the right ventricular outflow tract [ 11 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the overall transplant-free survival rate at 10 years was 90%, which aligns with the results of previous studies. Earlier studies identified factors associated with death or transplantation, including younger age, the need for an annular enlargement procedure, and associated congenital heart diseases [ 12 , 14 , 19 ]. However, in our study, we were unable to identify any factors associated with death or transplantation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes after Mechanical Aortic Valve Replacement in Children with Congenital Heart Disease

Kim,

Cho,

Kim

et al. 2023

J Chest Surg

View full text Add to dashboard Cite

Background:The optimal choice of valve substitute for aortic valve replacement (AVR) in pediatric patients remains a matter of debate. This study investigated the outcomes following AVR using mechanical prostheses in children. Methods: Forty-four patients younger than 15 years who underwent mechanical AVR from March 1990 through March 2023 were included. The outcomes of interest were death or transplantation, hemorrhagic or thromboembolic events, and reoperation after mechanical AVR. Adverse events included any death, transplant, aortic valve reoperation, and major thromboembolic or hemorrhagic event.Results: The median age and weight at AVR were 139 months and 32 kg, respectively. The median follow-up duration was 56 months. The most commonly used valve size was 21 mm (14 [31.8%]). There were 2 in-hospital deaths, 1 in-hospital transplant, and 1 late death. The overall survival rates at 1 and 10 years post-AVR were 92.9% and 90.0%, respectively. Aortic valve reoperation was required in 4 patients at a median of 70 months post-AVR. No major hemorrhagic or thromboembolic events occurred. The 5-and 10-year adverse event-free survival rates were 81.8% and 72.2%, respectively. In univariable analysis, younger age, longer cardiopulmonary bypass time, and smaller valve size were associated with adverse events. The cut-off values for age and prosthetic valve size to minimize the risk of adverse events were 71 months and 20 mm, respectively. Conclusion: Mechanical AVR could be performed safely in children. Younger age, longer cardiopulmonary bypass time and smaller valve size were associated with adverse events. Thromboembolic or hemorrhagic complications might rarely occur.

show abstract