[Heart valve prosthesis in children and adolescents with aortic valve insufficiency]. / Protezirovanie klapanov pri aortal'noi nedostatochnosti u detei i podrostkov

Aortic valve prosthetic replacement in children and adolescents helps to improve their haemodynamics, and favourably affects the course of the rheumatic process. The correction of the defect is indicated in the presence of appropriate subjective and objective symptoms of aortic valve insufficiency. The lumen of the aorta was so large in many children that it permitted the employment of prostheses for adults. Calcification of the aortic valve was found in 9 of the 31 patients, which contradicts the commonly accepted belief of a low incidence of calcification in this disease in children. Hospital mortality and postoperative complications rate did not exceed those in aortic valve replacement in adults. The comparatively fast reduction of the heart size and the positive dynamics of the functional parameters in children and adolescents may be due to the high plasticity of the cardiovascular system in this age-group.

[Results of the aortic valve prosthesis with a follow-up period of over 3 years]. / Rezul'taty protezirovaniia aortal'nogo klapana pri sroke nabliudeniia bolee 3 let

The results of the aortic valve prosthetics in 71 patients discharged from the A.N. Bakulev institute of Cardio-Vascular Surgery of the AMS of the USSR as far back as three and more years ago are analyzed. All these patients had been given implanted a Soviet-made ball-type prosthesis, model AK4-02. In 5 patients some additional operative interventions were performed. No indirect action anticoagulants were used. Nine patients (12.7 per cent) died late after the operation. Good, persistent results were achieved in 48 cases (67.6 per cent) with follow-up period ranging from 3 to 9 years. Major causes responsible for a reduced effect of surgery were thromboembolic complications, paravalvular fistulas and also uncorrected or inadequately corrected concomitant failures of other valves. Ways of increasing the effective prosthetics of the aortic valve with the ball-type prosthesis are discussed.