Homograft replacement of mitral valve in children.

作者信息

Plunkett M D, Schneider D J, Shah J J, Bash S E, Bond L M, Geiss D M

机构信息

Department of Pediatrics, University of Illinois College of Medicine and Children's Hospital of Illinois at St Francis Medical Center, Peoria, USA.

出版信息

Ann Thorac Surg. 1998 Sep;66(3):849-52. doi: 10.1016/s0003-4975(98)00645-6.

BACKGROUND

Recent reports have demonstrated successful early outcomes using mitral valve homografts in adults. We report our early results after homograft mitral valve replacement in 4 children with previous atrioventricular septal defects, previous placement of a prosthetic valve, and rheumatic valvular disease.

METHODS

Between May 1996 and June 1997, 4 children (ages 5, 11, 13, and 15 years) underwent mitral valve replacement with cryopreserved mitral valve homografts at our institution. Preoperative echocardiography confirmed moderately severe to severe mitral regurgitation, stenosis, or both in all 4 patients.

RESULTS

Successful homograft valve replacement was achieved in all 4 patients. Based on symptoms, physical examinations, and echocardiographic follow-up, all four homograft mitral valves are functioning well with normal hemodynamics. None of these patients are receiving warfarin. Follow-up has been limited to 10 months.

CONCLUSIONS

In children requiring mitral valve replacement, the use of mitral valve homografts offers advantages over prosthetic valves, such as the avoidance of complications associated with thrombosis and anticoagulation. Homograft mitral valve replacement is technically feasible in children with congenital and rheumatic heart disease and previous prosthetic valves.