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Ann Thorac Surg 2001;71:S353-S355
© 2001 The Society of Thoracic Surgeons

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Autografts, allografts, and biological valves in children

Results of up to 9 years of high-temperature- fixed valvular bioprostheses in a young population

^a Hôpital Européen Georges Pompidou, Paris, France
^b Heart Institute, Ho Chi Minh City, Viet Nam

Address reprint requests to Dr Alain Carpentier, Department of Cardiovascular Surgery and Organ Transplantation, Hôpital Europeen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France

Presented at the VIII International Symposium on Cardiac Bioprostheses, Cancun, Mexico, Nov 3–5, 2000.

Background. Bioprosthetic valve replacement in young patients remains a controversial issue due to a high rate of early calcification. Previous studies in our laboratory have shown that high-temperature fixation of glutaraldehyde preserved bioprosthesis (HTF) mitigates calcification. The first clinical application of this technique was started in 1991.

Methods. From January 1991 to September 1998, 50 patients in whom anticoagulants were contraindicated underwent single aortic valve replacement (n = 33) or mitral valve replacement (n = 17) using HTF bioprostheses. The age of the patients ranged from 7 months to 35 years (mean 22.7 ± 6.8 years). The mean New York Heart Association status was 2.4. Mean follow-up 4 years ± 1.8 for a total follow-up of 196 patient-years.

Results. There were no operative deaths and but there were two late deaths, one valve related. Structural failure occured in 4 patients (2%/patient-year) requiring a reoperation in 3 patients (1.5%/patient-year). No endocarditis or thromboembolic episodes were observed. At late examination (June 2000), 46 patients (92%) were in New York Heart Association class I or II, with a well functioning valve.

Conclusions. Replacement with HTF bioprostheses in young patients has demonstrated encouraging midterm results with a low incidence of structural failure

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