Vidne B, Levy M J
Thorax. 1970 Jan;25(1):57-61. doi: 10.1136/thx.25.1.57.
Twenty children with heart valve disease were operated upon and underwent heart valve replacement between 1965 and 1968. Thirteen were girls and seven boys. At the time of operation their ages ranged from 3 to 16 years. All the patients were in classes III or IV prior to operation. Three children suffered from congenital valvular lesions and 17 from rheumatic lesions. In each patient left and/or right heart catheterization and angiographic studies were performed. Six patients underwent aortic valve replacement, 11 mitral, 1 tricuspid, and 2 double valve replacement. Mitral annuloplasty was performed in addition to aortic valve replacement in two patients, and tricuspid annuloplasty in addition to mitral valve replacement in another patient. In 19 patients a prosthetic valve was used and in one an aortic heterograft (pig). Two patients died in the early postoperative period (10%), and two later, two and nine months after surgery (10%). Postoperative thromboembolism occurred in four patients (20%). All have completely recovered. All the surviving 16 patients have been followed for a period of one to four and a half years and all showed significant clinical improvement; all children of school age have returned to school and/or other normal actitivies. The overall result has been encouraging and might justify a more aggressive approach in the management of valvular diseases in this specific group of patients.
1965年至1968年间，20名患有心脏瓣膜疾病的儿童接受了心脏瓣膜置换手术。其中13名是女孩，7名是男孩。手术时他们的年龄在3岁至16岁之间。所有患者术前心功能分级均为Ⅲ级或Ⅳ级。3名儿童患有先天性瓣膜病变，17名患有风湿性病变。对每位患者均进行了左心和/或右心导管检查及血管造影研究。6例患者接受了主动脉瓣置换术，11例二尖瓣置换术，1例三尖瓣置换术，2例双瓣膜置换术。2例患者在主动脉瓣置换术的基础上进行了二尖瓣环成形术，另1例患者在二尖瓣置换术的基础上进行了三尖瓣环成形术。19例患者使用了人工瓣膜，1例使用了主动脉异种移植物（猪）。2例患者在术后早期死亡（10%），2例在术后较晚时间死亡，分别为术后2个月和9个月（10%）。4例患者发生了术后血栓栓塞（20%）。所有患者均已完全康复。所有存活的16例患者均已随访1至4年半，所有患者临床症状均有显著改善；所有学龄儿童均已返校和/或恢复其他正常活动。总体结果令人鼓舞，可能为对这一特定患者群体的瓣膜疾病采取更积极的治疗方法提供依据。
