Fate of left-sided cardiac bioprosthesis valves in XXXX .

@entity1 @entity340 @entity712 @entity339 @entity730 @entity1031 @entity4794 @entity15882 @entity850
To avoid anticoagulation and minimize @entity1031 phenomena, between 1975 and 1980 we used 18 porcine bioprosthetic valves (BPVs) to replace 11 aortic and seven mitral valves in 17 @entity1 ranging from 7 to 18 years of age (mean, 8.2 years). Ten BPVs (91%) in the aortic position had to be replaced one to six years (mean, 4.2 years) after insertion. Nine of these valves developed severe @entity730 with leaflet immobility and severe @entity850 . The tenth valve became insufficient with a disrupted cusp. Six (86%) of seven BPVs inserted in the mitral position required replacement two to four years (mean, 3.1 years) after insertion. Massive @entity339 developed in three, while in the other three @entity4794 was prominent. All explanted BPVs exhibited @entity730 with disruption and loss of mobility of the leaflets. Hemodynamic deterioration often occurred catastrophically, with nine @entity1 requiring @entity340 . Elective valve replacement carried no hospital mortality, whereas @entity340 carried a 33% mortality. The @entity15882 failure rate of 94% within six years leads us to recommend against the use of biologic valves in the pediatric age group in the aortic or mitral position. @entity712 may occur catastrophically and replacement should be carried out early to avoid the higher operative mortality associated with emergency surgery.
