Corecţia chirurgicală a valvulopatiilor la copii şi adolescenţi. Rezultate şi perespective

Abstract

Background: Valvular pathology in infants and children pose numerous problems such as valvular narrow rings, inconveniences of mechanical valves prosthesis, accelerated degeneration of bioprosthetic valves and homografts. Valvular repair is the goal of intervention, because restoration of valvular anatomy and function allows growth and avoids the problems of valvular substitution. When reconstruction fails or is not feasible, valve replacement becomes inevitable. The goal of this article is to address valve surgical options for all four valve positions within the pediatric sector. We review current literature and our practice to support our preferences. Material and methods: A group of 205 patients under the age of 18 with valvular pathology was operated on at our institution in 1988-2006. Results: Hospital mortality was 4.3% in aortic group and 5.4% in a mitral group of patients. Valvular repair was possible in 84% and 78.3% of each group respectively. Aortic annuloplasty was done in 6.4% of patients. We inserted minimal 21 mm prosthesis in a mitral position and 19 mm in aortic position. Long – term results need to be evaluated. Conclusions: A multitude of options and surgical experiences exist. Valvular repair remains a procedure of choice in a pediatric group of patients.