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ORIGINAL ARTICLE

Heart valve surgery in children and adolescents

Luís Roberto Gerola; Pablo M. A Pomerantzeff; Paulo M Pêgo-Fernandes; Noedir A. G Stolf; Miguel Barbero-Marcial; Munir Ebaid; Rachel Snitcowsky; Max Grinberg; Geraldo Verginelli; Adib D Jatene

DOI: 10.1590/S0102-76381990000300009

ABSTRACT

From January 1983 to December 1988, 131 patients with ages iqual or less than 15 years old were submitted to valve surgery; 74 (56%) were of acquired ethiology and 57 (44%) were congenital. In 100 (76.3%) patients operation was performed in only one valve. There were 63 valve replacements (re-replacement in six), 103 conservative procedures and in three valve exereses was performed. Among the 63 prosthesis, 59 (93.6%) were biological and 4 (6.3%) mechanical. Twenty-one patients (16%) were reoperated upon, 17 (81%) of them due to prosthesis dysfunction. The average time of calcification was 40 months (3.3 years). Hospitaly mortality was 7.5% and late mortality was 2.2%. In the follow-up of 2787 months/patient all of them were in fuctional class I or II (NYHA).

RESUMO

No período de janeiro de 1983 a dezembro de 1988, 131 pacientes, com idade igual ou inferior a 15 anos, foram submetidos a cirurgia valvar, 74 (56%) de etiologia adquirida e 57 (44%) de etiologia congênita. Em 100 (76,3%) pacientes somente uma valva foi tratada. Foram realizadas 63 trocas valvares (retroca em seis), 103 procedimentos conservadores e três exéreses valvares. Das 63 próteses utilizadas, 59 (93,6%) eram biológicas e 4 (6,3%) mecânicas. Vinte e um (16%) casos eram reoperações, sendo 17 (81%) por disfunção de prótese. O tempo médio de calcificação das biopróteses foi de 40 meses (3,3 anos). A mortalidade hospitalar foi de 7,5% e a tardia foi de 2,2%. No seguimento tardio de 787 meses/paciente, todos encontram-se em classe funcional I e II (NYHA).
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REFERENCES

1. ATTIE, F.; KURI, J.; ZANONIANI, C.; REUTENIO, V.; BUENDIO, A.; OVSEYEVITZ, J.; LOPES-SORIANO, F.; GARCIA, C. M.; MARTINEZ-RIOS, M. A. - Mitral valve replacement in children with rheumatic heart disease. Circulation, 64: 812-815, 1981.

2. BAYLEY, W. W.; KIRKLIN, J. W.; BARGERON, L. M.; PACÍFICO, A. D.; KOUCHOUKOS, N. T. - Late results with synthetic valves external conducts from venous ventricle to pulmonary arteries. Cardiovasc. Surg., 56: 73-78, 1977.

3. BERRY, B. E.; RITTER, D. G.; WALLACE, R. B.; McGOON, D. C.; DANIELSON, D. K. - Cardiac valve replacement in children. J. Thorac. Cardiovasc. Surg., 68: 705-710, 1974. [MedLine]

4. BLOODWELL, R. D.; HALLARAN, G. L; COOLEY, D. A. - Cardiac valve replacement in children. Surgery, 63: 77-89, 1968.

5. CARPENTIER, A. - Cardiac valve surgery: the french corretion. J. Thorac. Cardiovasc. Surg., 86: 323-337, 1983. [MedLine]

6. CARPENTIER, A.; CHAUVAUD, S.; FABIANI, J. M.; DELOCHE, A.; RELLAND, J.; LESSANA, A.; D'ALLAINES, C.; BLONDEAU, P.; PIWNICA, A.; DUBOST, C. - Reconstrutive surgery of mitral valve incompetence: ten-years appraisal. J. Thorac. Cardiovasc. Surg., 79: 338-348, 1980. [MedLine]

7. CARPENTIER, A.; CHAUVAUD, S.; NOSÉ, L.; RELLAND, J.; MICHILEANU, S.; MARINO, J. P.; ABRY, B.; GUIBOURT, P. - A new reconstrutive operation for Ebstein anomaly of the tricuspid valve. J. Thorac. Cardiovasc. Surg., 96: 92-101, 1988. [MedLine]

8. CHAUVAUD, S.; PIRIER, P.; TONATI, G.; RELLAND, J.; KARA, S. M.; CARPENTIER, A. - Long term results of valve repair in children with acquired mitral valve incompetence. Circulation, 74 (Supl. 1): 104-109, 1986.

9. CIAROVELLA, J. M.; McGOON, D. C.; DANIELSON, G. K.; WALLACE, L. B.; MAIR, D. C. - Experience with the extracardiac conduit. J. Thorac. Cardiovasc. Surg., 78: 920-930, 1979. [MedLine]

10. CHEN, S.; LAKS, H.; FOGAN, C.; RERSCHLUSE, D.; KAISER, G.; BARNER, H. H.; WILLIMAN, V. L. - Valve replacement in children. Circulation, 56 (Supl. 2): 117-121, 1977.

11. DUNN, J. M.; - Porcine valve durability in children. Ann. Thorac. Surg., 32: 357-368, 1981. [MedLine]

12. ELOY, R.; FERREIRA, A.; CARVALHO, H.; BRITO, J. C.; TADEU, E.; NERY, A. C.; RIBEIRO, A.; OLIVEIRA, R.; RIBEIRO, N. - Cirurgia orovalvar na criança: experiência de 135 casos. Rev. Bras. Cir. Cardiovasc., 1: 24-28, 1986.

13. GALIOTO, F. M.; MIGDLEY, F. M.; SHAPIRO, S. P.; PERRY, L. W.; CHAVARELLA, J. M.; SCOTT, L. P. - Mitral valve replacement in infants and children. Pediatrics, 67: 230-235, 1981. [MedLine]

14. GARDNER, T. J.; ROLAND, J. M. A.; NEILLE, C. A.; DONAHHOO, J. S. - Valve replacement in children: a fifteen years perspective. J. Thorac Cardiovasc. Surg., 83: 178-185, 1982. [MedLine]

15. GEHA, A. S.; LAKS, A.; STANSEL Jr., H. C.; CORNHILL, J. F.; KILMAN, J. N.; BUCKLEY, M. J.; ROBERTS, W. C. - Late failure of porcine valve heterografts in children. J. Thorac Cardiovasc Surg., 78: 351-364, 1979. [MedLine]

16. GIMENES, A. C.; BUFFOLO, E.; FORTE, V.; ANDRADE, J. S. C.; GOODY, M.; SUCCI, J. E.; GIMENES, V. M.; CURY, A.; GALLUCI, C. - Resultados tardios (mais que 5 anos) de pacientes portadores de valva homóloga montada em suporte na substituição de valvas cardíacas. Rev. Bras. Med., 34: 48-52, 1976.

17. GODOY, M. F.; BRANCO, J. N; SOARES, H. C.; LEÃO, L. E. V.; CARVALHO, A. C. C.; GIMENEZ, A. C.; RIBEIRO, E.; SUCCI, J. E.; ANDRADE, J. C.; ALBERTINS M. V.; VENTRIGLIA, C. R. B.; BUFFOLO, E.; GALLUCCI, C. - Relato a longo prazo da substituição valvar em crianças. Arq. Brasil. Cardiol., 37: 325-329, 1981.

18. HUMAN, D. G.; JOFFE, H. S.; FRASER, C. B. - Mitral valve replacement in children. J. Thorac. Cardiovasc Surg., 83: 873-877, 1982. [MedLine]

19. JOHN, S.; BASHI, V. V.; JAIRA, J.; MURALIDHARAM, S.; RAVIKUMAR, I. P. - Mitral valve replacement in the young patient with rheumatic heart disease. J. Thorac Cardiovasc Surg., 86: 209-216, 1983. [MedLine]

20. KOPF, G. S.; GEHA, A. S.; HELLENBRAND, W. E.; KLEINMAN, C. S. - Fate of left-side cardiac bioprosthesis valves in children. Arch. Surg., 121: 488-490, 1986. [MedLine]

21. LEVY, R. J.; ZENKER, J. A.; LION, J. B. - Vitamin k-depleted calcium binding proteins in aortic valve calcification. J. Clinic. Invest., 65: 563-566, 1980.

22. MATHEW, R. A.; PARK, S. C.; NECHES, D. H.; LENOX, C. C.; ZUBERBUHLER, J. R.; LERBERG, D. B.; BAHNSON, H. T. - Valve replacement in children and adolescent. J. Thorac Cardiovasc. Surg., 73: 872-878, 1977.

23. MILANO, A., BORTOLOTTI, V.; TALENTE, E.; VALFRÈ, C.; ARBUSTINI, E.; VALENTE, M.; MAZZUCO, A.; GALLUCI, V.; THIENE, G. - Calcific degeneration as the main cause of porcine bioprosthetic failure. Am. J. Cardiol., 53: 1066-1070, 1984. [MedLine]

24. MILLER, D. C.; STINSON, E. B.; OYER, P. E.; BILLINGHAN, M. E.; PITLICK, P. T.; REITZ, B. A.; JAMIESON, S. W.; BAUMGARTNER, W. A.; SHUMWAY, N. E. - The durability of porcine xenograft valves and conduct in children. Circulation, 66: 172-185, 1982.

25. PASS, H. I.; SADE, R. M.; CRAWFORD, F. A.; HOLM, A. - Cardiac valve prosthesis in children without anticoagulation. J. Thorac. Cardiovasc. Surg., 87: 832-835, 1984. [MedLine]

26. PUIG, L. B.; VERGINELLI, G.; SOSA, E. A.; ROMA, L. S. L.; GARCIA, D.; CONCEIÇÃO, A. N. - Avaliação hemodinâmica da valva de dura-máter mitral e tricúspide. Arq. Bras. Cardiol.; 29: 297-301, 1976. [MedLine]

27. ROCCHINI, A. P.; WEESNER, K. M.; HEIDELBERG, K.; KEREN, D.; BEHRENDT, B.; ROSENTHAL, A. - Porcine xenograft valve failure in children: an immunologic response. Circulation, 64 (Supl. 2): 162-171, 1981.

28. RUPPRATH, G.; FRANKE, F.; VOGT, J.; De VIVIE, E. R. - Long term results after mitral and aortic valve replacement childhoold and adolescence. Z. Kardiol., 75 (Supl. 2): 312-317, 1986.

29. RUPPRATH, V. J.; De VIVIE, E. R.; BEUREN, A. J. - Conduit repair for complex congetinal heart disease with pulmonary atresia or right ventricular outflow tract obstruction. Part II: Early and late hemodynamic and echocardiographic findings. J. Thorac. Cardiovasc. Surg., 29: 337-341, 1981.

30. SADE, R. M.; BALLENGER, J. F.; HEHN, A. R.; QUANTS, J. E.; RIOPEL, D. A.; TAYLOR, A. B. - Cardiac valve replacement in children: comparison of tissue with mechanical prothesis. J. Thorac. Cardiovasc. Surg., 78: 123-127, 1979. [MedLine]

31. SANDER, S. P.; LEVY, R. J.; FREED, M. B.; NORWOOD, D. I.; CASTAÑEDA, A. R. - Use of Hancock porcine xenografts in children and adolescents. Am. J. Cardiol., 46: 429-438, 1980. [MedLine]

32. SCHACHNER, A.; SALOMON, J.; LEON, L.; LEONARD, C. B.; LEVY M. J. - Prosthetic valve replacement in infants and children. J. Thorac. Cardiovasc. Surg., 25: 537-544, 1984.

33. SILVER, M. M.; PALLOCKF, J. S.; WILLIAMS, W. G.; TRUSLER, G. A. - Calcification in porcine xenograft valves in children. Am. J. Cardiol., 45: 685-689, 1980. [MedLine]

34. SMITH, J. M.; COOLEY, D. A.; OTT, D. A.; FERREIRA, W.; RUEL Jr., G. A. - Aortic valve replacement in children. Ann. Thorac. Surg. 29: 512-518, 1980. [MedLine]

35. STANTON, R. E.; GALLAGHER, M. E.; MEYER, B. W.; LINDESMITH, G. G.; STILES, A. R. - Replacement of cardiac valves in children. Am. J. Dis. Child., 120: 503-510, 1970. [MedLine]

36. SULAYAMAN, R.; MATTHEW, R.; HICENIUS, O. G.; REPLAGE, R.; ARCILLA, R. A. - Hemodynamics and annuloplasty in isolated mitral regurgitation in children. Circulation, 52: 1144-1155, 1975.

37. TEXEIRA NETO, J. A.; STOLF, N. A. G.; PUIG, L. B.; SOSA, E.; PILEGGI, F.; BITTENCOURT, D.; VERGINELLI, G.; ZERBINI, E. J. - Substituição de valvas cardíacas por próteses em crianças e pacientes jovens. Arq. Brasil. Cardiol., 28: 409-415, 1975.

38. THADROYEN, F. T.; WILTON, I. N.; PIRIE, D.; ROGERS, M. A.; MITHA, A. S. - Severe calcification of glutaraldehyde preserved porcine xenografts in children. Am. J. Cardiol., 45: 690-696, 1980. [MedLine]

39. THIENE, G.; BORTOLOTTI, V.; PANIZZON, C.; MILANO, A.; GALUCCI, V. - Pathological substrates of thrombus formation after heart valve replacement with the Hancock bioprosthesis. J. Thorac. Cardiovasc. Surg., 80: 414-423, 1980. [MedLine]

40. VERRIER, E. D.; GRANBAUGH, R. F.; SAIFER, S. J.; YEE, E. S.; TURLEY, K.; EBERT, P. A. - Aspirin anticoagulation in children with mechanical aortic valves. J. Thorac. Cardiovasc. Surg., 92: 1013-1020, 1986. [MedLine]

41. VOUHÉ, P. R.; MILANO, A.; LECO, F.; NEVEUX, J. Y. - Aortic and mitral valve replacement in young patients Z. Kardiol., 75 (Supl. 2): 289-293 - 1986.

42. WEINSTEIN, G. S.; MARROUDIS, C.; EBERT, P. A. - Preliminary experiences with aspirin anticoagulation in children with prosthetic cardiac valves. Ann. Thorac. Surg., 33: 549-554, 1982.

43. WILLIAMS, D. B.; DANIELSON, G. K.; McGOON, D. C.; PUGA, F. J.; MAIR, D. D.; EDWARDS, W, D. - Porcine heterograft valve replacement in children. J. Thorac. Cardiovasc. Surg., 84: 446-450, 1982. [MedLine]

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