小児期弁置換術の問題点 : 特に術後抗凝固療法について

概要

論文の詳細を見る
The valve replacement has been performed in 18 children less than 15 years of age between 1968 and 1985. These valve replacements consisted of 8 left atrio-ventricular valve replacements, 7 aortic valve replacements, 2 right atrio-ventricular valve replacements and one pulmonary valve replacement. Ault-sized prosthetic valves were implanted in all cases except for three cases of less than five years of age. There were seven operative deaths. Of the 11 operative survivors, one death occurred within the cumulative follow-up period of 49.74 patient-years. The remaining 10 patients improved by at least one NYHA class and all are in Functional class I. Thrombo-embolic episode was encountered in one child who had sick sinus syndrome after MVR. In this patient, Dipyridamole and Aspirin were given for anticoagulation. Hemorrhagic complications occurred in 6 cases who were maintained on Warfarin medication, but thrombo-embolism was never seen in 9 patients with Warfarin. Based on these clinical experiences, we believe that prosthetic valve replacement is a reliable method for children with severe valvular heart diserses in spite of the difficulty and inherent dangers in controlling dosage of anticoagulant drugs.
日本小児外科学会の論文
1987-05-20