Clinical outcomes of pulmonary valve replacement surgery in pediatrics: a single-center experience long-term study

Introduction: Heart valve disease in pediatricsis an increasing global concern, especially in developing countries. This study aims to determine the clinical outcomes of pulmonary valve replacement (PVR) surgery in pediatrics. Methods: The authors retrospectively identified all pediatrics undergoing PVR surgery at Imam Reza hospital (Mashhad, Iran) between ۲۰۰۰ and ۲۰۲۰. Their medical records were reviewed for demographic characteristics, clinical data (intra-operative and postoperative), and follow-up results. Echocardiography and electrocardiography were performedonall patients before the surgery and periodically after the surgery. Results: Among ۵۰ pediatrics undergoing surgical PVR, ۳۸ (۷۶%) were female and others were male (۱۴%), with a mean age of ۱۰.۳۹±۵.۳۱ years. The leading cause of PVR was the Tetralogy of Fallot. There was a significant relationship between age at the time of surgery and the size of the pulmonary valve(P=۰.۰۲).There were also statistically significant differences between QTc intervals before and after surgery (P=۰.۰۰۱). Further more, there was a significant correlation between QTc intervals before and after surgery and the ageof pediatrics at the time of surgery (P=۰.۰۱, r=-۰.۶).There was also a statistically significant relationship between the ICU stay (P=۰.۰۱) and the weaning time of the mechanical ventilation (P=۰.۰۳). Conclusion: It is recommended that this procedure ispostponed as much as possible to decrease postoperative life-threatening events in pediatrics.In addition, if this surgery is conducted with good surgical and nursing management, it can be safe with low complications among other cardiac valve procedures.

Keywords:

Congenital Heart Disease , Pulmonary Valve Atresia , Pulmonary Valve Insufficiency , Pulmonary Valve Stenosis , Tetralogy of Fallot