Valve Replacement in Children

Borman, Joseph B.; Shimon, D; Deeb, Maher; Simcha, A.

doi:10.1111/j.1540-8191.1989.tb00288.x

Cited by 3 publications

(5 citation statements)

References 108 publications

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“…The reduction in the proportions of patients remaining in the third or fourth functional classes after surgery shows the significant improvement in symptoms following surgery, results again similar to those reported by other authors 11 . Even though the results did not reach statistical significance, the patients with mechanical prostheses had a longer reoperation-free survival as compared with those with biological prostheses, another finding in accordance with previous reports 8 , 9 , 20 – 24 …”

Section: Discussionsupporting

confidence: 91%

“…11 Even though the results did not reach statistical significance, the patients with mechanical prostheses had a longer reoperation-free survival as compared with those with biological prostheses, another finding in accordance with previous reports. 8,9,[20][21][22][23][24] Regarding the indications for reoperation, it proved necessary to replace 3 biological prostheses because of degenerative calcification leading to stenosis, and in 1 instance because of endocarditis. For mechanical prostheses, 4 needed replacement because of thrombosis, and another again because of endocarditis.…”

Section: Discussionmentioning

confidence: 99%

“…The discussion about the type of prosthesis to be used in young patients dates back to the beginning of replacement of valves. The American Heart Association 7 have recommended the use of mechanical prostheses in adolescent and young patients, based on studies showing a shorter durability of the biological valves in that age group 8 – 11 . In this study, we have analysed data on mortality, reoperation, haemorrhage, and strokes in children and adolescents undergoing valvar replacement according to the type of prosthesis implanted.…”

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confidence: 99%

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Comparison of mechanical and biological prostheses when used to replace heart valves in children and adolescents with rheumatic fever

et al. 2009

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Comparison of mechanical and biological prostheses when used to replace heart valves in children and adolescents with rheumatic fever

et al. 2009

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“…However, the majority of authors argue in favor of the use of mechanical prostheses only in patients of this age 7 . This tendency is explained by the fact that long-term follow-up of the evolution of bioprostheses has demonstrated a high incidence of complications connected to degradation with precocious calcification, requiring re-operation [8][9][10] .…”

Section: Discussionmentioning

confidence: 99%

Immediate and long term evolution of valve replacement in children less than 12 years old

Atik

Dias

Pomerantzeff

et al. 1999

Arq. Bras. Cardiol.

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Atik et al Valve replacement in childrem less than 12 years old Arq Bras Cardiol volume 73, (nº 5), 1999 Immediate and Long Term Evolution of Valve Replacement in Children Less than 12 Years Old Original ArticleThe high prevalence of rheumatic fever in infants and adolescents draws attention to the peculiarities of the disease, which frequently causes serious valves dysfunction often in association with conditions of rheumatic activity of the cardiac muscle. Due to their important hemodynamic repercussions, such conditions may at times require urgent surgical intervention 1 .Conservative surgical procedures, a primary approach to these cases, are often not possible due to pathological alterations present in cardiac valves. On the other hand, valve replacement in infants and adolescents has its own set of difficulties, in particular, which prostheses types and size to use.The aim of this work is to present the immediate and long-term experience of our valve replacement service with children under 12 years of age, with the aim of identifying the ideal prosthesis for use at this age group. MethodsForty-four patients under 12 years of age who underwent to valve replacement at the Heart Institute, Hospital of Clinics, University of São Paulo Medical School between January 1986 and December 1992, were retrospectively analyzed.Twenty-three (52.3%) were males between 2 and 12 years of age (average age 10 years). Their valve diseases were of rheumatic in origin in 40 (91%), degenerative in 2 (4.5%) and congenital in 2 (4.5%) of the cases. Twenty (45.5%) of the patients were in preoperative NYHA functional class IV, 19 (43.2%) were in functional class III and 5 (11.3%) were in functional class II of the NYHA scale. Nineteen (43.2%) had emergency operations, 6 (13.6%) had chronic atrial fibrillation and 13 (29.5%) showed laboratory and scintigraphic evidence of rheumatic activity.Valve replacements were performed in the mitral position in 30 patients (68.2%), in the aortic position in 8 (18.2%) and in the tricuspid position in one (2.3%). Five (11.3%) patients were underwent double mitral and aortic valve replacement.

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“…These drugs exert their actions through a high-affinity central BDZ binding site, which is associated with the GABAA/CIionophore complex [9]. The complex is formed by and arrangement of three types of subunits: a, p, and y.…”

Section: Introductionmentioning

confidence: 99%

Properties of selective type I benzodiazepine receptor ligands

Villar

Loew

1991

Int. J. Quantum Chem.

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Conformational studies on zolpidem, and ICI 190,622, three type I selective benzodiazepine receptor ligands, are presented. The semiempirical quantum mechanical AM 1 technique was used, and all possible torsions were rotated systematically in 30" increments. In addition, each of the structures was subjected to molecular dynamics simulation at 3 10 K, to study their conformational flexibility at physiologically relevant temperatures. Zolpidem and 2-oxoquazepam have two low-energy conformers each that can not interconvert. By contrast, ICI 190,622 has several low-energy equilibrium structures, each of which could be accessed from any other minimum in the simulation. For each of these three selective analogs, for CL 2 18,872, and for the nonselective diazepam, flunitrazepam, and triazolam, steric and electronic properties were calculated and examined for their role as determinants of type 1 receptor recognition and selectivity. Specifically, the "sterimol" parameters, which provide quantitative measures of the shape, and heats of protonation for each analog were calculated. The geometric parameter that describes the maximum separation between any two points on the molecular surface appears to be a good discriminant of selectivity.

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Valve Replacement in Children

Cited by 3 publications

References 108 publications

Comparison of mechanical and biological prostheses when used to replace heart valves in children and adolescents with rheumatic fever

Comparison of mechanical and biological prostheses when used to replace heart valves in children and adolescents with rheumatic fever

Immediate and long term evolution of valve replacement in children less than 12 years old

Properties of selective type I benzodiazepine receptor ligands

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