Document Detail

Small aortic root in childhood: surgical options.
MedLine Citation:
PMID:  7979725     Owner:  NLM     Status:  MEDLINE    
Aortic valve replacement in the pediatric population is complicated by the often complex nature of the left ventricular outflow tract obstruction. Techniques to enlarge the annulus frequently are necessary. From 1977 to 1991, 32 children underwent an annular enlargement procedure at The Hospital for Sick Children, Toronto. During this same era, 110 children underwent a total of 138 aortic valve replacements. Eleven had the annulus enlarged with a posterior patch technique and implantation of a valve (mechanical 8, porcine heterograft 2, homograft 1) ranging from 20 to 25 mm in diameter. Twenty-two children had an anterior annular enlargement (aortoventriculoplasty) and aortic valve replacement with a valve (mechanical 8, porcine 2, homograft 12) 12 to 27 mm in diameter. One child had a posterior patch enlargement performed, followed by a second operation involving anterior annular enlargement. There was one early death in the posterior annuloplasty group and one late death due to failure of a bioprosthetic valve. There were five hospital deaths in the anterior annuloplasty group (22%; 70% confidence interval [CI], 14% to 32%) and two late deaths. Actuarial survival for the 32 children was 78% (70% CI, 70% to 86%) at 5 years and 65% (70% CI, 48% to 82%) at 10 years after repair. Younger children (age less than 1 year) had a significantly worse survival at 5 years (33%; 70% CI, 14% to 52%) than older children (88%; 70% CI, 82% to 95%). The survivors are well, and no reoperations have been necessary because of the children's outgrowing their valve.
D B Ross; G A Trusler; J G Coles; I M Rebeyka; J Smallhorn; W G Williams; R M Freedom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  58     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1994-12-28     Completed Date:  1994-12-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1617-24; discussion 1625     Citation Subset:  AIM; IM    
Division of Cardiac Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
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MeSH Terms
Age Factors
Aorta / abnormalities*,  surgery*
Aortic Valve
Aortic Valve Stenosis / surgery
Child, Preschool
Heart Valve Prosthesis*
Infant, Newborn
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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