Intermediate-term results in pediatric aortic valve replacement
Background. Aortic valve replacement (AVR) in children is now more commonly performed with human tissue valves. Methods. The results of 100 consecutive pediatric AVRs (50 mechanical, 50 human) were reviewed. Results. There were five perioperative deaths in the mechanical group and one in the human g...
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| Veröffentlicht in: | The Annals of thoracic surgery 1999-08, Vol.68 (2), p.521-525 |
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| container_title | The Annals of thoracic surgery |
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| creator | Lupinetti, Flavian M Duncan, Brian W Scifres, Aaron M Fearneyhough, Collette T Kilian, Karen Rosenthal, Geoffrey L Cecchin, Frank Jones, Thomas K Herndon, S.Paul |
| description | Background. Aortic valve replacement (AVR) in children is now more commonly performed with human tissue valves.
Methods. The results of 100 consecutive pediatric AVRs (50 mechanical, 50 human) were reviewed.
Results. There were five perioperative deaths in the mechanical group and one in the human group (
p = 0.2). Late complications in the mechanical group included 4 late deaths, 2 cases of endocarditis, 3 thromboembolic complications, and 10 reoperations on the aortic valve. In the human group, there were no late deaths, 2 reoperations for allograft aortic valve deterioration (both in Marfan’s patients), and 1 reoperation for allograft pulmonary valve stenosis. Four-year actuarial survival was 83% in the mechanical group and 98% in the human group (
p = 0.02). Four-year actuarial survival free of all valve-related complications was 61% in the mechanical group and 88% in the human group (
p = 0.008).
Conclusions. Human valves in children requiring AVR provide superior intermediate-term survival and freedom from valve-related complications compared to mechanical valves. Marfan’s syndrome may represent a rare remaining contraindication for human AVR in children. |
| doi_str_mv | 10.1016/S0003-4975(99)00642-6 |
| format | Article |
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Methods. The results of 100 consecutive pediatric AVRs (50 mechanical, 50 human) were reviewed.
Results. There were five perioperative deaths in the mechanical group and one in the human group (
p = 0.2). Late complications in the mechanical group included 4 late deaths, 2 cases of endocarditis, 3 thromboembolic complications, and 10 reoperations on the aortic valve. In the human group, there were no late deaths, 2 reoperations for allograft aortic valve deterioration (both in Marfan’s patients), and 1 reoperation for allograft pulmonary valve stenosis. Four-year actuarial survival was 83% in the mechanical group and 98% in the human group (
p = 0.02). Four-year actuarial survival free of all valve-related complications was 61% in the mechanical group and 88% in the human group (
p = 0.008).
Conclusions. Human valves in children requiring AVR provide superior intermediate-term survival and freedom from valve-related complications compared to mechanical valves. Marfan’s syndrome may represent a rare remaining contraindication for human AVR in children.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(99)00642-6</identifier><identifier>PMID: 10475422</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Actuarial Analysis ; Adolescent ; Adult ; Aortic Valve - abnormalities ; Aortic Valve - surgery ; Aortic Valve - transplantation ; Bioprosthesis ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Defects, Congenital - mortality ; Heart Defects, Congenital - surgery ; Heart Valve Prosthesis Implantation ; Humans ; Infant ; Male ; Postoperative Complications - mortality ; Postoperative Complications - surgery ; Prosthesis Failure ; Reoperation ; Survival Rate ; Transplantation, Autologous ; Transplantation, Homologous</subject><ispartof>The Annals of thoracic surgery, 1999-08, Vol.68 (2), p.521-525</ispartof><rights>1999 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-57d978db91813cc950c61f798caf983000285dc5ea7c8fad6d7d95ffc3ace7e23</citedby><cites>FETCH-LOGICAL-c425t-57d978db91813cc950c61f798caf983000285dc5ea7c8fad6d7d95ffc3ace7e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-4975(99)00642-6$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,46004</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10475422$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lupinetti, Flavian M</creatorcontrib><creatorcontrib>Duncan, Brian W</creatorcontrib><creatorcontrib>Scifres, Aaron M</creatorcontrib><creatorcontrib>Fearneyhough, Collette T</creatorcontrib><creatorcontrib>Kilian, Karen</creatorcontrib><creatorcontrib>Rosenthal, Geoffrey L</creatorcontrib><creatorcontrib>Cecchin, Frank</creatorcontrib><creatorcontrib>Jones, Thomas K</creatorcontrib><creatorcontrib>Herndon, S.Paul</creatorcontrib><title>Intermediate-term results in pediatric aortic valve replacement</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. Aortic valve replacement (AVR) in children is now more commonly performed with human tissue valves.
Methods. The results of 100 consecutive pediatric AVRs (50 mechanical, 50 human) were reviewed.
Results. There were five perioperative deaths in the mechanical group and one in the human group (
p = 0.2). Late complications in the mechanical group included 4 late deaths, 2 cases of endocarditis, 3 thromboembolic complications, and 10 reoperations on the aortic valve. In the human group, there were no late deaths, 2 reoperations for allograft aortic valve deterioration (both in Marfan’s patients), and 1 reoperation for allograft pulmonary valve stenosis. Four-year actuarial survival was 83% in the mechanical group and 98% in the human group (
p = 0.02). Four-year actuarial survival free of all valve-related complications was 61% in the mechanical group and 88% in the human group (
p = 0.008).
Conclusions. Human valves in children requiring AVR provide superior intermediate-term survival and freedom from valve-related complications compared to mechanical valves. Marfan’s syndrome may represent a rare remaining contraindication for human AVR in children.</description><subject>Actuarial Analysis</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aortic Valve - abnormalities</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve - transplantation</subject><subject>Bioprosthesis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Defects, Congenital - mortality</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - surgery</subject><subject>Prosthesis Failure</subject><subject>Reoperation</subject><subject>Survival Rate</subject><subject>Transplantation, Autologous</subject><subject>Transplantation, Homologous</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtOxCAUhonROOPoI2i6MrqoAi2lrCZm4mWSSVyoa8LQQ4LpTaCT-PbS6cS4c3UO8B1--BC6JPiOYFLcv2GMszQXnN0IcYtxkdO0OEJzwlhsKBPHaP6LzNCZ959xSePxKZoRnHOWUzpHy3UbwDVQWRUgHdvEgR_q4BPbJv1-31mdqM6FWHaq3kEk-lppaKAN5-jEqNrDxaEu0MfT4_vqJd28Pq9XD5tU55SFlPFK8LLaClKSTGvBsC6I4aLUyogyG19WskozUFyXRlVFFQeYMTqLORxotkDX0729674G8EE21muoa9VCN3jJMSY0y3EE2QRq13nvwMje2Ua5b0mwHM3JvTk5apFCyL05WcS5q0PAsI06_kxNqiKwnACI39xZcNJrC62OihzoIKvO_hPxA5jwfj4</recordid><startdate>19990801</startdate><enddate>19990801</enddate><creator>Lupinetti, Flavian M</creator><creator>Duncan, Brian W</creator><creator>Scifres, Aaron M</creator><creator>Fearneyhough, Collette T</creator><creator>Kilian, Karen</creator><creator>Rosenthal, Geoffrey L</creator><creator>Cecchin, Frank</creator><creator>Jones, Thomas K</creator><creator>Herndon, S.Paul</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990801</creationdate><title>Intermediate-term results in pediatric aortic valve replacement</title><author>Lupinetti, Flavian M ; Duncan, Brian W ; Scifres, Aaron M ; Fearneyhough, Collette T ; Kilian, Karen ; Rosenthal, Geoffrey L ; Cecchin, Frank ; Jones, Thomas K ; Herndon, S.Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-57d978db91813cc950c61f798caf983000285dc5ea7c8fad6d7d95ffc3ace7e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Actuarial Analysis</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aortic Valve - abnormalities</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve - transplantation</topic><topic>Bioprosthesis</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Defects, Congenital - mortality</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - surgery</topic><topic>Prosthesis Failure</topic><topic>Reoperation</topic><topic>Survival Rate</topic><topic>Transplantation, Autologous</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lupinetti, Flavian M</creatorcontrib><creatorcontrib>Duncan, Brian W</creatorcontrib><creatorcontrib>Scifres, Aaron M</creatorcontrib><creatorcontrib>Fearneyhough, Collette T</creatorcontrib><creatorcontrib>Kilian, Karen</creatorcontrib><creatorcontrib>Rosenthal, Geoffrey L</creatorcontrib><creatorcontrib>Cecchin, Frank</creatorcontrib><creatorcontrib>Jones, Thomas K</creatorcontrib><creatorcontrib>Herndon, S.Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lupinetti, Flavian M</au><au>Duncan, Brian W</au><au>Scifres, Aaron M</au><au>Fearneyhough, Collette T</au><au>Kilian, Karen</au><au>Rosenthal, Geoffrey L</au><au>Cecchin, Frank</au><au>Jones, Thomas K</au><au>Herndon, S.Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intermediate-term results in pediatric aortic valve replacement</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1999-08-01</date><risdate>1999</risdate><volume>68</volume><issue>2</issue><spage>521</spage><epage>525</epage><pages>521-525</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>Background. Aortic valve replacement (AVR) in children is now more commonly performed with human tissue valves.
Methods. The results of 100 consecutive pediatric AVRs (50 mechanical, 50 human) were reviewed.
Results. There were five perioperative deaths in the mechanical group and one in the human group (
p = 0.2). Late complications in the mechanical group included 4 late deaths, 2 cases of endocarditis, 3 thromboembolic complications, and 10 reoperations on the aortic valve. In the human group, there were no late deaths, 2 reoperations for allograft aortic valve deterioration (both in Marfan’s patients), and 1 reoperation for allograft pulmonary valve stenosis. Four-year actuarial survival was 83% in the mechanical group and 98% in the human group (
p = 0.02). Four-year actuarial survival free of all valve-related complications was 61% in the mechanical group and 88% in the human group (
p = 0.008).
Conclusions. Human valves in children requiring AVR provide superior intermediate-term survival and freedom from valve-related complications compared to mechanical valves. Marfan’s syndrome may represent a rare remaining contraindication for human AVR in children.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>10475422</pmid><doi>10.1016/S0003-4975(99)00642-6</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via ScienceDirect (Elsevier); Alma/SFX Local Collection |
| subjects | Actuarial Analysis Adolescent Adult Aortic Valve - abnormalities Aortic Valve - surgery Aortic Valve - transplantation Bioprosthesis Child Child, Preschool Female Follow-Up Studies Heart Defects, Congenital - mortality Heart Defects, Congenital - surgery Heart Valve Prosthesis Implantation Humans Infant Male Postoperative Complications - mortality Postoperative Complications - surgery Prosthesis Failure Reoperation Survival Rate Transplantation, Autologous Transplantation, Homologous |
| title | Intermediate-term results in pediatric aortic valve replacement |
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