CARBOMEDICS(R) VALVE IN CONGENITAL HEART-DISEASE - MIDTERM FOLLOW-UP-STUDY OF 14 PATIENTS

In 14 patients aged 5-329 (mean 131) months a CarboMedics(R) valve was implanted because of congenital heart disease. The preoperative NYHA function class was III-IV ten cases. Seven aortic and seven atrioventr icular 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 postoperativel y. Thrombosis occurred in four valves, three in tricuspid and one in m itral position. In all patients who received only warfarin, anticoagul ation was demonstrably inadequate. Consequently we now recommend antip latelet medication in addition to warfarin for children with atriovent ricular mechanical valve replacement. In our experience the complicati on rate with CarboMedics prosthesis is acceptable, provided that antic oagulant therapy is adequate.