Williams W G, Pollock J C, Geiss D M, Trusler G A, Fowler R S
J Thorac Cardiovasc Surg. 1981 Mar;81(3):326-33.
Ninety-two children underwent aortic (AVR) or mitral valve replacement (MVR), or both, at the Hospital for Sick Children in Toronto from 1963 to February, 1980. No early or late deaths occurred in 39 children having AVR. However, in 50 children having MVR, the operative mortality was 32% and the actuarial survival rate 5 years after operation was only 50%. Major complications occurred with almost equal frequency in the two groups; 50% of children surviving AVR or MVR experienced major complications within 6 years of operation. Retrospective comparison of results with tissue and mechanical valves showed no clear advantage with either type of prosthesis. Outgrowth of a prosthetic valve was satisfactorily managed in children with AVR but presented a difficult problem in those with MVR, who required frequent reoperation to increase the prosthetic valve to adult size. Prosthetic valve replacement in children is a palliative procedure at best, and every effort should be made to preserve the natural valve by a more conservative repair technique.
1963年至1980年2月期间，92名儿童在多伦多病童医院接受了主动脉瓣置换术（AVR）或二尖瓣置换术（MVR），或两者皆有。接受AVR的39名儿童未发生早期或晚期死亡。然而，在接受MVR的50名儿童中，手术死亡率为32%，术后5年的精算生存率仅为50%。两组主要并发症的发生频率几乎相同；接受AVR或MVR存活的儿童中有50%在术后6年内出现主要并发症。对组织瓣膜和机械瓣膜的结果进行回顾性比较，未发现哪种类型的假体有明显优势。接受AVR的儿童中人工瓣膜增生得到了满意的处理，但在接受MVR的儿童中这是一个难题，他们需要频繁再次手术以将人工瓣膜增大到成人尺寸。儿童人工瓣膜置换充其量只是一种姑息性手术，应尽一切努力通过更保守的修复技术保留天然瓣膜。
