Asian Cardiovasc Thorac Ann 2007;15:476-481
© 2007 Asia Publishing EXchange Ltd
Prosthetic Valve Replacement in Adolescents with Rheumatic Heart Disease
Raja P Akhtar, FRCS,
Abdul R Abid, MBBS1,
Hasnain Zafar, MBBS,
Saqib S Sheikh, FCPS1,
Masud A Cheema, FRCS,
Jawad S Khan, FRCS
Department of Cardiac Surgery
1 Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan
For reprint information contact: Raja P Akhtar, FRCS Tel: 92 30 0846 5515 Fax: 92 42 920 0028 email: rajapakhtar{at}gmail.com, Punjab Institute of Cardiology, Ghaus-ul-Azam Road, Lahore, Pakistan.
To assess long-term survival and anticoagulant-related complications after mechanical valve replacement in adolescents with rheumatic heart disease, 88 patients aged 
18 years were prospectively followed up for 10 years (404.2 patient-years). There were 58 (65.9%) boys and 30 (34.1%) girls, with a mean age of 15.4 ± 2.1 years. Mitral regurgitation was detected in 39 (44.3%) patients, and both mitral and aortic regurgitation in 15 (17%). Ball valves were inserted in 52 (59.1%) patients, bileaflet valves in 31 (35.2%), and single-disc valves in 5 (5.7%). There were 4 (4.5%) hospital deaths and 11 late deaths. Patient survival at 30 days, 3 months, 1, 5, and 10 years was 95.5%, 93.2%, 87.5%, 82.9%, and 82.9%, respectively. Mechanical valve thrombosis occurred in 4 patients; it was fatal in 3 of them. Three patients died from stroke. Severe hemorrhage required hospital admission in 4 (4.5%) patients. Mechanical valve replacement in adolescents, with careful follow-up and anticoagulation, has acceptable long-term results.
Copyright © 2007 by the Asia Publishing EXchange Ltd.
