Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objective: We analyzed the survival, clinical course, and role of prosthesis-patient mismatch after systemic atrioventricular valve replacement in children.
Methods: From 1974 to 2006, 69 patients underwent systemic atrioventricular valve replacement (median age 1.2 years, range 1.1 months to 5.4 years), with 17 patients requiring re-replacement of the systemic atrioventricular valve. Prosthesis-patient relationship was analyzed by comparing (1) the prosthetic valve diameter and the predicted annulus diameter based on the body surface area and (2) the prosthetic valve diameter and the measured annulus diameter.
Results: Survival was 73% at 1 year and 65% at 5, 10, and 15 years. Age, weight, body surface area, predicted annulus diameter, prior surgery, underlying disease, and ratio of prosthetic valve diameter to body weight were significant predictors of death. Variables associated with re-replacement of the systemic atrioventricular valve were body surface area, prosthetic valve diameter, predicted annulus diameter, and presence of multiple left-sided obstructive lesions. The majority of patients received a prosthesis larger than the predicted annulus diameter. There was good correlation between the prosthetic valve diameter and the measured annulus diameter (r = 0.85). Mismatch, as described by the difference in z scores of prosthetic valve diameter and measured annulus diameter, was not a significant predictor of death or re-replacement of the systemic atrioventricular valve.
Conclusions: Although valve replacement is considered the last therapeutic option after failed attempts of valvuloplasty, long-term outcome is favorable. Selection of the prosthesis is made on the basis of the measured annulus diameter. An elevated ratio of prosthetic valve diameter to body weight is associated with patients with low body weight or a large native annulus in dilated ventricles.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtcvs.2007.04.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Early experience with a prefabricated bioprosthetic aortic valved conduit: The first 100.
JTCVS Open
August 2025
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
Objective: To evaluate the early postoperative morbidity, mortality, and prosthetic conduit function of patients who underwent aortic root replacement using a prefabricated bioprosthetic aortic valved conduit.
Methods: Single-center retrospective review of 124 consecutive adult patients who underwent aortic root replacement with a certified prefabricated bioprosthetic aortic valved conduit from 2021 to December 2023.
Results: Indications for operation were aortic aneurysms (n = 92), endocarditis (n = 12), deterioration of prior valve prosthesis (n = 13), and aortic dissection (n = 6).
Lactobacillus Bacteremia Following Dental Instrumentation in a Patient With a Bioprosthetic Valve.
Cureus
August 2025
Internal Medicine, Ronald Reagan University of California Los Angeles Medical Center, Los Angeles, USA.
Although generally considered harmless commensals or beneficial probiotics, species can act as opportunistic pathogens under certain clinical conditions. We describe a case of high-grade bacteremia in a 59-year-old man with a history of aortic root dilation status post Bentall procedure and bioprosthetic aortic valve replacement. The suspected source was recent dental instrumentation.
View Article and Find Full Text PDFAortic Valve Replacement with Annular Patch Reconstruction for Prosthetic Valve Endocarditis after the Bentall Procedure: A Case Series.
Surg Case Rep
August 2025
Department of Cardiac and Vascular Surgery, Dokkyo Medical University School of Medicine, Shimotsugagun, Tochigi, Japan.
Introduction: Prosthetic valve endocarditis following aortic root replacement (ARR) typically necessitates redo-ARR, which involves complete graft removal, extensive aortic root dissection, and coronary reimplantation. This highly invasive procedure carries substantial surgical risk, including high operative mortality. In select high-risk patients without evidence of prosthetic graft infection, alternative surgical strategies may reduce procedural complexity and improve outcomes.
View Article and Find Full Text PDFSalvage repair of complete aortic root detachment after Bentall procedure: a case of LVOT elongation.
Multimed Man Cardiothorac Surg
September 2025
Department of Cardiovascular Surgery, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey.
Complete detachment of the aortic root following a Bentall procedure is an exceptionally rare complication. The vast majority of reported cases are secondary to prosthetic valve endocarditis or underlying vasculitis. Currently, the most reliable treatment for aortic root dehiscence-particularly in the context of prosthetic valve endocarditis-is repeat root replacement, typically via a second Bentall procedure or with the use of a homograft or allograft.
View Article and Find Full Text PDFInfectious endocarditis caused by Elizabethkingia spp.: Two case reports and a literature review.
J Infect Public Health
September 2025
Department of Infectious Disease, Dijon Bourgogne University hospital, Dijon Cedex, France. Electronic address:
We report two cases of Elizabethkingia-related infective endocarditis, highlighting key risk factors such as prosthetic valve replacement. These cases underscore the need to consider endocarditis in the setting of persistent or recurrent bacteremia. Diagnosis proved challenging and required multiple imaging modalities, with positron emission tomography (PET) scan providing critical value when echocardiography was non-contributory.
View Article and Find Full Text PDF