Aortic valve replacement in young patients: long-term follow-up
Douglas S. Moodie, MDAddress reprint requests to D.S.M., Department of Cardiology, The Cleveland Clinic Foundation, 9500 Elucid Avenue, Cleveland, OH 44195
Usama Hanhan, MD
Richard Sterba, MD
Daniel J. Murphy, MD
Eliot R. Rosenkranz, MD
Andrea M. Kovacs, BS
Thirty-four young patients (28 male and 6 female) underwent aortic valve replacement between 1972 and 1988. Ages ranged from 11 to 20 years (mean 17.7 years). Including reimplantation in the follow-up period, 40 valves were implanted, among which were 17 (43%) St. Jude, 7 (16%) Bjork-Shiley, and 4 (10%) Carpentier-Edwards. Seven patients (18%) had tissue valve prostheses (4 Carpentier-Edwards, 3 Hancock valves). There was one hospital death (2.9%). Follow-up was obtained in 30 of the 33 hospital survivors, with a mean follow-up of 80 months. In the follow-up period, one patient (3%) had a major thromboembolic event and one patient (3%) had prosthetic valve endocarditis. Six patients (18%) required replacement of the implanted valve; three of these had received Hancock tissue valve prostheses. There were three late deaths, yielding 96% survival at 5 years and 84% at 10 years. Twenty-three of 30 survivors are currently New York Heart Association class I. Aortic valve replacement in young patients can be performed with low mortality and morbidity, and with excellent long-term results.