Garretano Alejandra, Abella Raul, Doblas Joaquin Fernández, Catalán Antonio Pamiès, Codina Paola Dolader, Ipiña Ferran Gran, Godoy Laura Marfil, Blasco Pedro Betrián
Paediatric Interventional Cardiology Unit, Vall d'Hebron Hospital, Paseo de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
Pediatric Cardiac Surgery Department, Vall d'Hebron Hospital, Paseo de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
Eur Heart J Case Rep. 2024 Dec 5;8(12):ytae642. doi: 10.1093/ehjcr/ytae642. eCollection 2024 Dec.
The Edwards Sapien percutaneous valve (Edwards Lifesciences, Irvine, CA, USA) is a promising therapeutic option for congenital atrioventricular disease mostly because of the possibility to accommodate somatic growth with balloon dilatation.
This article reports the performance of the Edwards Sapien 3 valve in atrioventricular valve position in four paediatric patients.
Despite aggressive antiplatelet and anticoagulation strategies, most patients showed early bioprosthesis dysfunction, with increasing gradient not related with somatic growth. The decrease in leaflet motility in the absence of thrombosis or pannus could be associated with the low-velocity flow and low-pressure gradient that exists between the atria and ventricles in small children. It is well-known graft lifespan is usually shorter in small children, but we hypothesize the possibility of a second factor that valve design is intended to support higher flow-velocity patterns and can present an early failure in low-flow low-pressure situation. More studies are necessary to provide reliable evidence.
爱德华 Sapien 经皮瓣膜（美国加利福尼亚州尔湾市爱德华生命科学公司）是先天性房室疾病一种很有前景的治疗选择，主要是因为有可能通过球囊扩张适应身体生长。
本文报道了4例儿科患者的爱德华 Sapien 3瓣膜在房室瓣位置的性能。
尽管采取了积极的抗血小板和抗凝策略，但大多数患者早期出现生物瓣膜功能障碍，压差增加与身体生长无关。在无血栓形成或血管翳的情况下瓣叶活动度降低可能与小儿心房和心室之间存在的低速血流和低压差有关。众所周知，小儿的人工瓣膜寿命通常较短，但我们推测可能存在第二个因素，即瓣膜设计旨在支持更高流速模式，在低流量低压情况下可能会早期失效。需要更多研究来提供可靠证据。
