Progress of surgical treatment for aortic valve diseases in children / 中华外科杂志

ABSTRACT

As the primary treatment of aortic valve stenosis in children, surgical aortic valvotomy (SAV) and balloon aortic valvuloplasty (BAV) are widely used. With the similar early curative effect to BAV, SAV performs better in long-term follow-up. But the first choice for aortic valve stenosis is still controversial. These years, aortic valve repair is valued and different repair techniques have been reported and achieved good results. The complex repair techniques, as leaflet extension, leaflet replacement or valve reconstruction, are effective in treating diseased valves that cannot be repaired before. Ozaki technology, using glutaraldehyde-treated autologous pericardium to replace the aortic valve, makes the surgery more standardized and reproducible by developing special instruments. Pulmonary autograft (Ross procedure) is considered to be superior to other valve replacement technologies due to the good hemodynamic performance and lower reoperation rate. Mechanical valve is still used in some cases, but the quality of life is low due to the lifelong anticoagulation, and it has a high reintervention rate. The biological valve has been rarely used in children because of its high rate of early calcification and structural failure.