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PubMed · 8062789

Prosthetic heart valve.

A L Wellford·L A Wellford
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Abstract

There are tens of thousands of patients with prosthetic heart valves implanted today, and although complications are infrequent, this may not hold true as patients live longer with prosthetic valves and as more and newer valves are implanted. A familiarity with the management of such patients will aid the emergency physician in the evaluation of this increasing population of patients and will enable the early detection of potentially deadly complications.

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BioprosthesisEmergenciesHeart Valve ProsthesisHumansProsthesis FailureJournal ArticleReview

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BibTeXRIS

A L Wellford, L A Wellford. 1994. Prosthetic heart valve.. https://pubmed.ncbi.nlm.nih.gov/8062789/

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PubMed2007

Early outcomes of tricuspid valve replacement in young children.

BACKGROUND: Early outcomes after tricuspid valve replacement in young children are ill defined. The experience of the Pediatric Cardiac Care Consortium (45 centers, 1984 to 2002) was reviewed to evaluate the results of tricuspid valve replacement in children <6 years of age. METHODS AND RESULTS: Ninety-seven patients who underwent initial tricuspid valve replacement are included in the present analysis. The most frequent cardiac diagnoses were Ebstein's anomaly (40%), pulmonary atresia (11%), and tetralogy of Fallot (8%). Age at tricuspid valve replacement was 2.9+/-1.7 years (mean+/-SD). Mean patient weight was 12.7+/-6.1 kg. The major outcome was survival to discharge. Associations among age, diagnosis, valve type/size, and outcome were evaluated through the use of chi2 analysis and logistic regression model fitting approaches. Hospital mortality was 26% and was very high (64%) in patients <1 year of age. A large size-to-weight ratio was the strongest predictor of mortality based on multivariable analysis (P<0.001). Mortality was 54% for patients with a size-to-weight ratio >2.5. Other complications included heart block requiring a pacemaker (13%) and thrombosis (5%). Pacemaker implantation was associated with the use of a mechanical valve (23% versus 6% bioprosthetic valve; P=0.01) CONCLUSIONS: Tricuspid valve replacement in young children is associated with high mortality, especially in infants <1 year of age. Surgical options other than tricuspid valve replacement such as transplantation may need to be considered in infants.

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