Outcomes and associated risk factors for aortic valve replacement in 160 children : A competing-risks analysis

• Published in: Circulation (New York, N.Y.) N.Y.), 2005-11, Vol.112 (22), p.3462-3469
• Main Authors: KARAMLOU, Tara, JANG, Karen, WILLIAMS, William G, CALDARONE, Christopher A, VAN ARSDELL, Glen, COLES, John G, MCCRINDLE, Brian W
• Format: Article
• Language: English
• Subjects: Adolescent; Aortic Valve - surgery; Biological and medical sciences; Bioprosthesis; Blood and lymphatic vessels; Cardiology. Vascular system; Child; Child, Preschool; Coronary heart disease; Disease-Free Survival; Diseases of the aorta; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Echocardiography; Female; Heart; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Infant; Infant, Newborn; Male; Medical sciences; Prosthesis Failure; Retrospective Studies; Risk Assessment; Risk Factors; Survival Rate; Transplantation, Autologous; Treatment Outcome
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.105.541649

We sought to define patient characteristics, outcomes, and associated risk factors after aortic valve replacement (AVR) in children. Clinical records from children undergoing AVR from 1974 to 2004 at our institution were reviewed. Competing-risks methodology determined the time-related prevalence of 3 mutually exclusive end states: death, repeated replacement, and survival without subsequent AVR and their associated risk factors. Longitudinal echocardiographic data were analyzed by mixed linear-regression models. Children (n=160) underwent 198 AVRs, with 33 having >1. Competing-risks analysis predicted that 10 years from the initial AVR, 19% had died without subsequent AVR, 34% underwent a second AVR, and 47% remained alive without replacement. Risk factors for death without a second AVR included lower weight (P