Key result
CarboMedics valve implantation in congenital heart disease shows low mortality but ~29% valve thrombosis.
Why the study?
The midterm outcomes and complication rates of CarboMedics valve implantation in congenital heart disease patients were not well characterized.
Cohort (n=14)
CarboMedics valve implantation in congenital heart disease has acceptable midterm outcomes, but the high rate of thrombosis on warfarin alone prompts a recommendation for combined warfarin and antiplatelet therapy for atrioventricular replacements in children.
Acceptable midterm outcomes with CarboMedics valves in congenital disease; leaves open optimal antithrombotic regimen.
In 14 patients aged 5-329 (mean 131) months a CarboMedics valve was implanted because of congenital heart disease. The preoperative NYHA function class was III-IV in ten cases. Seven aortic and seven atrioventricular valves were replaced without early mortality. All patients were followed up, with mean observation time 27 months (total 384 months). One of the 14 patients died of heart failure 10 months postoperatively. Thrombosis occurred in four valves, three in tricuspid and one in mitral position. In all patients who received only warfarin, anticoagulation was demonstrably inadequate. Consequently we now recommend antiplatelet medication in addition to warfarin for children with atrioventricular mechanical valve replacement. In our experience the complication rate with CarboMedics prosthesis is acceptable, provided that anticoagulant therapy is adequate.
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Fiane et al. (1994) conducted a cohort in Congenital heart disease (n=14). CarboMedics valve implantation was evaluated on Mortality and valve thrombosis. CarboMedics valve implantation in 14 patients with congenital heart disease resulted in 0 early deaths, 1 late death, and 4 cases of valve thrombosis over a mean follow-up of 27 months.
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