Aim of the study – to analyze outcomes after aortic valve replacement in children aged under 18 years old treated with pulmonary autograft prosthesis (Ross procedure) and with mechanical valve prosthesis.
Materials and methods. From 2003 to 2018 Ross procedure was performed in 56 patients and mechanical valve prosthesis (MVP) was performed in 42 patients with aortic valve pathology. Long term follow up was available in 81 patients (44 in Ross group and 37 in MVP group). Mean age in Ross group made up 3.6 ± 3.2 years, mean weight 16.4 ± 9.7 kg. Mean age in MVP group made up 7.7 ± 5.8 years, mean weight 30 ± 19 kg. Mean follow up period was 6 ± 4.4 years.
Results. Early and late mortality in Ross group made up 3,6 and 6,8% respectively. Actuarial freedom from reintervention after 5 and 10 years was 86 and 69% respectively. All reinterventions were exclusively on right ventricle outflow tract. Trombus formation, tromboembolic complication and infective endocarditis were not observed. In MVP group early and late mortality accounted for 7.1 and 2.7% respectively. Actuarial freedom from reintervention after 5 and 10 years – 79 and 79% respectively. Tromboembolism occurred in 1 (2.7%) patient. One (2.7%) patient with mechanical valve developed late infective endocarditis. Echo showed better hemodynamic parameters in Ross group in all but two patients.
Conclusion. Acceptable results were achieved in both groups. Taking into account relatively high mortality rate and need for reoperation in young children with MVP, we consider that Ross procedure is more preferable for them.
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About the authors
- Konstantin V. Shatalov, Dr. Med. Sc., Professor, Head of Department, ORCID
- АMagomed A. Abdurazakov, Postgraduate, Cardiovascular Surgeon, ORCID
- Ravil M. Muratov, Dr. Med. Sc., Professor, Head of Department, ORCID
- Irina V. Arnautova, Dr. Med. Sc., Cardiovascular Surgeon, ORCID
- Konstantine M. Dzhidzhikhiya, Cand. Med. Sc., Cardiovascular Surgeon, ORCID