HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): David B. Ross George A. Trusler John G. Coles Ivan M. Rebeyka William G. Williams Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ross, D. B. Articles by Freedom, R. M. Search for Related Content PubMed PubMed Citation Articles by Ross, D. B. Articles by Freedom, R. M.

Ann Thorac Surg 1994;58:1617-1624
© 1994 The Society of Thoracic Surgeons

---

Articles

Small aortic root in childhood: Surgical options

Divisions of Cardiac Surgery and Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada

Accepted for publication March 14, 1994.

^_* Address reprint requests to Dr Ross, I.W.K. Hospital for Children, PO Box 3070, Halifax, Canada B3M 3G9.

Aortic valve replacement in the pediatric population is complicated by the often complex nature of the left ventricular outflow tract obstruction. Techniques to enlarge the annulus frequently are necessary. From 1977 to 1991, 32 children underwent an annular enlargement procedure at The Hospital for Sick Children, Toronto. During this same era, 110 children underwent a total of 138 aortic valve replacements. Eleven had the annulus enlarged with a posterior patch technique and implantation of a valve (mechanical 8, porcine heterograft 2, homograft 1) ranging from 20 to 25 mm in diameter. Twenty-two children had an anterior annular enlargement (aortoventriculoplasty) and aortic valve replacement with a valve (mechanical 8, porcine 2, homograft 12) 12 to 27 mm in diameter. One child had a posterior patch enlargement performed, followed by a second operation involving anterior annular enlargement. There was one early death in the posterior annuloplasty group and one late death due to failure of a bioprosthetic valve. There were five hospital deaths in the anterior annuloplasty group (22%; 70% confidence interval [CI], 14% to 32%) and two late deaths. Actuarial survival for the 32 children was 78% (70% CI, 70% to 86%) at 5 years and 65% (70% CI, 48% to 82%) at 10 years after repair. Younger children (age less than 1 year) had a significantly worse survival at 5 years (33%; 70% CI, 14% to 52%) than older children (88%; 70% CI, 82% to 95%). The survivors are well, and no reoperations have been necessary because of the children's outgrowing their valve.

This article has been cited by other articles:

				E. Erez, K. R. Kanter, V. K.H. Tam, and W. H. Williams Konno aortoventriculoplasty in children and adolescents: from prosthetic valves to the ross operation Ann. Thorac. Surg., July 1, 2002; 74(1): 122 - 126. [Abstract] [Full Text] [PDF]

				V. A. Starnes, G. B. Luciani, W. J. Wells, R. B. Allen, and A. B. Lewis Aortic Root Replacement With the Pulmonary Autograft in Children With Complex Left Heart Obstruction Ann. Thorac. Surg., August 1, 1996; 62(2): 442 - 448. [Abstract] [Full Text]

				J. A. M. van Son, V. M. Reddy, M. D. Black, H. Rajasinghe, G. S. Haas, and F. L. Hanley MORPHOLOGIC DETERMINANTS FAVORING SURGICAL AORTIC VALVULOPLASTY VERSUS PULMONARY AUTOGRAFT AORTIC VALVE REPLACEMENT IN CHILDREN J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1149 - 1157. [Abstract] [Full Text]