Skip to main content

Prosthetic Valves

  • Chapter
  • First Online:
Critical Care of Children with Heart Disease
  • 3804 Accesses

Abstract

Many challenges are faced by pediatric patients and their surgeons in finding acceptable replacement heart valves for diseased, diminutive, or absent native valves. First of the challenges is valve size. Many prosthetic valves available in the market today are applicable only to the largest of pediatric patients. Even the smallest of commercially available valves can have unacceptable gradients. This can, at times, be circumvented by various surgical techniques, annular enlargement, or valve positioning. Other obstacles faced in this patient population include the issues of somatic growth, valve calcification, structural deterioration, thromboembolism, and the need for anticoagulation and its associated monitoring requirements. This chapter reviews the currently available prosthetic valves, valve choice for various locations and indications in the pediatric patient, and lastly, management and complications of prosthetic valve placement in children. (Figs. 29.1 and 29.2 demonstrate currently available prosthetic and tissue valves.)

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Butchart EG, Hui-Hua L, Payne N, et al. Twenty years of experience with the medtronic heart valve. J Thorac Cardiovasc Surg. 2001;121:1090–1100.

    Article  PubMed  CAS  Google Scholar 

  2. Edwards MS, Russell GB, Edwards AF, et al. Results of value replacement with conscience mechanical prosthesis. Ann Thorac Surg. 2002;74:665–670.

    Article  PubMed  Google Scholar 

  3. Kiziltan HT, Theodoro DA, Warnes CA, et al. Late results of bioprosthetic ticuspid valve replacement in Epstein’s anomaly. Ann Thorac Surg. 1998;66:1539–1545.

    Article  PubMed  CAS  Google Scholar 

  4. Husain SA, Brown JW. When reconstruction fails or is not feasible: valve replacement options in the pediatric population. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2007;10:117–124.

    Article  Google Scholar 

  5. Gunther T, Mazzitelli D, Schrieber C, et al. Mitral valve replacement in children under 6 years of age. Eur J Cardiothorac Surg. 2000;17:426–430.

    Article  PubMed  CAS  Google Scholar 

  6. Kadoba K, Jonas RA, Mayer JE, Castañeda PR. Mitral valve replacement in the first year of life. J Thorac Cardiovasc Surg. 1990;100:762–768.

    PubMed  CAS  Google Scholar 

  7. Eble BK, Fiser WP, Simpson P, et al. Mitral valve replacement in children: predictors of long term outcome. Ann Thorac Surg. 2000;76:853–860.

    Article  Google Scholar 

  8. Doorn CV, Yates R, Tsang V, et al. Mitral valve replacement in children: mortality, morbidity and haemodynamic status up to medium term follow up. Heart. 2000;84:636–642.

    Article  PubMed  Google Scholar 

  9. Alexiou C, Galogavrou M, Chen Q, et al. Mitral valve replacement with mechanical prostheses in children: improved operative risk and survival. Eur J Cardiothorac Surg. 2001;20:105–113.

    Article  PubMed  CAS  Google Scholar 

  10. Daou L, Sidi D, Maunat P, et al. Mitral valve replacement with mechanical valves in children under two years of age. J Thorac Cardiovasc Surg. 2001;121:5.

    Article  Google Scholar 

  11. Beierlein W, Becker V, Yates R, et al. Long term follow-up after mitral valve replacement in childhood: poor event free survival in the young child. Eur J Cardiothorac Surg. 2007;31:860–865.

    Article  PubMed  Google Scholar 

  12. Caldarone CA, Raghuveer G, Hills CB, et al. Long term survival after mitral valve replacement in children aged <5 years. Circulation. 2001;104:143–147.

    Article  Google Scholar 

  13. Sachweh JS, Tiete AR, Mühler EG, et al. Mechanical aortic and mitral valve replacement in infants and children. Thorac Cardiovasc Surg. 2007;55:156–162.

    Article  PubMed  CAS  Google Scholar 

  14. Kabbani S, Jamil H, Nabhani F, et al. Analysis of 92 mitral pulmonary autograft replacement (Ross II) operations. J Thorac Cardiovasc Surg. 2007;134:902–908.

    Article  PubMed  Google Scholar 

  15. Chambers JC, Somerville J, Stone S, Ross DN. Pulmonary autograft procedure for aortic valve disease; long term results of the pioneer series. Circulation. 1997;96:2206–2214.

    Article  PubMed  CAS  Google Scholar 

  16. Forbess JM, Shah AS, et al. Cryopreserved homografts in the pulmonary position: determinants. Ann Thorac Surg. 2001;71:54–60.

    Article  PubMed  CAS  Google Scholar 

  17. Weipert J, Meisner H, Mendler N, et al. Allograft implantation in pediatric cardiac surgery; surgical experience from 1982 to 1994. Ann Thorac Surg. 1998;60:S101–S104.

    Article  Google Scholar 

  18. Oury JH, Hiro SP, Maxwell JM, et al. The Ross procedure current registry results. Ann Thorac Surg. 1998;46:S164.

    Google Scholar 

  19. Perron J, Moran AM, Gauvreau K, del Nido PJ, Mayer JE Jr, Jonas RA. Valved homograft conduit repair of the right heart in early infancy. Ann Thorac Surg. 1999;68:542–548.

    Article  PubMed  CAS  Google Scholar 

  20. Dearani JA, Danielson GK, Puga FJ, et al. Late follow-up of 1095 patients undergoing operation for complex congenital heart disease utilizing pulmonary ventricle to pulmonary artery conduits. Ann Thorac Surg. 2003;75:408.

    Article  Google Scholar 

  21. Fukada Y, Matsui Y, Sasaki S, Yasuda K. A case of mitral valve replacement with a collar-reinforced prosthetic valve for heavily calcified mitral annulus. Ann Thorac Cardiovasc Surg. 2005;11:260–263.

    PubMed  Google Scholar 

  22. Breymann T, Thies WR, Boethig D, et al. Bovine value venous xeografts for RVOT reconstruction results after 71 implantations. Eur J Cardiothoracic Surg. 2001;21:708.

    Google Scholar 

  23. Haas F, Schreiber C, Horer J, et al. Is there a role for mechanical valved conduits in the pulmonary position. Ann Thorac Surg. 2005;79:1662–1668.

    Article  PubMed  Google Scholar 

  24. Waterbolk TW, Hoenderings ES, den Hamer LJ, Ebels T. Pulmonary valve replacement with a mechanical prosthesis. Promising results of 28 procedures in patients with congenital heart disease. Eur J Cardiothorac Surg. 2006;30:28–34.

    Article  PubMed  Google Scholar 

  25. Rosti L, Morfi B, Coll AM, et al. Pulmonary valve replacement: a role for mechanical prosthesis. Ann Thorac Surg. 1999;65:889.

    Google Scholar 

  26. Champsaur G, Robin J, Tronc F, et al. Mechanical valve in the aortic position is a valid option in adolescents and children. Eur J Cardiothorac Surg. 1997;11:117–122.

    Article  PubMed  CAS  Google Scholar 

  27. Turrentine MW, Ruzmetov M, Vijay P, Bills RG, Brown JW. Biological versus mechanical aortic valve replacement in children. Ann Thorac Surg. 2001;71:S356–S360.

    Article  PubMed  CAS  Google Scholar 

  28. Shanmugam G, MacArthur K, Pollock J. Mechanical aortic valve replacement: long-term outcomes in children. J Heart Valve Dis. 2005;14:166–171.

    PubMed  Google Scholar 

  29. Lupinetti FM, Duncan BW, Scifres AM, et al. Intermediate-term results in pediatric aortic valve replacement. Ann Thorac Surg. 1999;68:521–526.

    Article  PubMed  CAS  Google Scholar 

  30. Alexiou C, McDonald A, Langley SM, et al. Aortic valve replacement in children: are mechanical prosthesis a good option. Eur J Cardiothorac Surg. 2000;17:125–133.

    Article  PubMed  CAS  Google Scholar 

  31. Sanders SP, Levy RJ, Free MD, Norwood WI, Casteñeda AR. Use of the Hancock porcine xenografts in children and adolescents. Am J Cardiol. 1980;46:429–438.

    Article  PubMed  CAS  Google Scholar 

  32. Geha AS, Laks H, Stansel HC. Late failure of porcine valve heterografts in children. J Thorac Cardiovasc Surg. 1979;78:351–364.

    PubMed  CAS  Google Scholar 

  33. Ruzmetov M, Palaniswamy V, Rodefeld MD, Turrentine MW, Brown JW. Evolution of aortic valve replacement in children: a single center experience. Int J Cardiol. 1996;113:194–200.

    Article  Google Scholar 

  34. Gerosa G, McKay R, Ross DN. Replacement of the aortic valve or root with a pulmonary autograft in children. Ann Thorac Surg. 1991;51:424–429.

    Article  PubMed  CAS  Google Scholar 

  35. Takkenberg JJM, Klieverik LMA, Bekkers JA, et al. Allografts for aortic valve or root replacement: insights from an 18 year single-center prospective follow-up study. Eur J CardioThorac Surg. 2007;31:851–859.

    Article  PubMed  Google Scholar 

  36. Emery RW, Nicoloff DM. The St Jude Medical cardiac valve prosthesis: in vitro studies. J Thorac Cardiovasc Surg. 1979;78:269–276.

    PubMed  CAS  Google Scholar 

  37. Vongpatanasin W, Hillis LD, Lange RA. Prosthetic heart valves. N Engl J Med. 1998;335:407–416.

    Article  Google Scholar 

  38. Cannagieter SC, Rosendaal FR, Briet E. Thromboembolic and bleeding complications in patients with mechanical heart prosthesis. Circulation. 1994;89:635–641.

    Article  Google Scholar 

  39. Mazzitelli D, Guenther T, Schrieber C, et al. Aortic valve replacement in children: are we on the right track? Eur J Cardiothoarc Surg. 1998;13:565–571.

    Article  CAS  Google Scholar 

  40. Iyer KS, Reddy SK, Rao IM, et al. Valve replacement in children under 20 years of age. Experience with the Bjork-Shiley prosthesis. J Thorac Cardiovasc Surg. 1984;88:217–224.

    PubMed  CAS  Google Scholar 

  41. Milano A, Vouhé PR, Baillot-Vernant F, et al. Late results after left-sided cardiac valve replacement in children. J Thorac Cardiovasc Surg. 1986;92:218–225.

    PubMed  CAS  Google Scholar 

  42. Larsen SH, Houlind K, Hansen OK, et al. Medium-term follow-up of mechanical valves inserted in children. Cardiol Young. 2006;16:579–585.

    Article  PubMed  Google Scholar 

  43. Grunkemeier GL, Naftel DC, Starr A, Rahimtoola SH. Long-term performance of heart valve prostheses. Curr Probl Cardiol. 2000;25:73–154.

    Article  PubMed  CAS  Google Scholar 

  44. Monagle P, Chan A, Massicotte P, Chalmers E, Michelson AD. Antithrombotic therapy in children the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. 2004;126:645S–687S.

    Article  PubMed  CAS  Google Scholar 

  45. Salem DN, Stein PD, Amin AH, et al. Antithrombotic therapy in valvular heart disease-native and prosthetic. Chest. 2004;126:457S–482S.

    Article  PubMed  CAS  Google Scholar 

  46. Devron J, Moran AM, Gauvreau K, et al. Valued homograft conduit repair of the right heart in early infancy. Ann Thorac Surg. 1999;68:542–548.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peter D. Wearden .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag London Limited

About this chapter

Cite this chapter

Wearden, P.D. (2009). Prosthetic Valves. In: Munoz, R., Morell, V., Cruz, E., Vetterly, C. (eds) Critical Care of Children with Heart Disease. Springer, London. https://doi.org/10.1007/978-1-84882-262-7_29

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-262-7_29

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-261-0

  • Online ISBN: 978-1-84882-262-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics