Abstract
Objective. To study common complications in children and juveniles after aortic valve replacement in long-term
period.
Material and methods. 120 patients were examined. Mean age at the moment of examination was 12.7±3.3
years, time after operation was 4.6±3.2 years. Aortic valve replacement with standard method was performed
in 78 patients, Manouguian-Seybold-Epting - 34 patients, Konno procedure - 5 patients, Nicks procedure - 3
patients. Prostheses sized ranged from 17th to 27th . Data analysis of clinical examination, ECG, international
normalized ratio (INR) were analyzed. The study was observation, retrospective.
Results. Most of patients were referred to higher functional class (FC) after the operation: FC I included
67 patients (55.8%), FC II - 44 (36.7%) and FC III - 5 (4.2%). In 4 patients (3.3%) FC was not possible to identify
due to restriction of functional capabilities after previous acute cerebrovascular disease (ACVD). Various heart
rhythm disturbances were seen in 16 patients (13.3%), 30 patients (25%) had insufficient values of (INR).
Thromboembolic complications with ACVD development were seen in 4 patients (3.3%), bleeding was seen
in the family history of 6 patients (5%). Aortal valve prosthesis dysfunction was detected in 13 patients (10.8%).
10 patients were reoperated, there was no mortality, 3 patients waiting for surgery. All procedures were successfully
performed. There was no mortality. The causes for prosthesis dysfunction in reoperated patients: thrombosis
of prosthesis due to discontinue of taking warfarin (n=1), fibrous pannus on prosthesis (n=4), pannus prosthesis
and paraprosthetic fistula (n=3); prosthesis size mismatch to physical development of a patient (n=3).
Conclusion. Children and juveniles are required in constant case follow-up after aortic valve replacement.
Support of adequate target ranges of INR is of primary importance to prevent thromboembolic and haemorrhagic
complications after implantation of mechanical prosthesis
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