Thesis

Paediatric heart valve disease and treatment : current status and future perspective on the need for better valve replacement technologies

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Awarding institution
  • University of Strathclyde
Date of award
  • 2012
Thesis identifier
  • T13301
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Qualification Name
Department, School or Faculty
Abstract
  • Valve repair is the treatment of choice for paediatric congenital heart valve disease, but valve replacement may still be necessary if repair strategies fail or if a valve is extensively damaged.(1) Paediatric-size heart valves available include biological, bioprosthetic and mechanical valves. These current valve replacement technologies still have significant limitations, including valve degeneration and dysfunction.(2) As a result, a patient may require numerous valve re-replacements. The need to 'redo' a valve replacement combined with the need for growth potential, over an individual's lifespan, are critical considerations in paediatric treatment strategies. Alternative approaches and solutions for valve substitutes need to be sought. The aim of this dissertation is therefore to compile a literature review of the currently available and newly emerging heart valve replacement technologies for paediatric use. The review identifies the paediatric population that may benefit from heart valve prostheses, the associated procedural complications, together with indications for valve replacement interventions. The limitations of such technologies are explored, focusing on reoperation rate, revision surgery, somatic growth and the potential to overcome the problems associated with intervention. Critical design outcomes are discussed, investigating questions relating to the selection of materials, device implantation or deployment and removal. The use of minimally invasive procedures, particularly catheter-based techniques, is looked at as an alternative to open heart surgery. This includes percutaneous valve replacement with the potential for valve-in-valve replacements. Finally, the future direction in which such technologies are likely to go are discussed, pointing out what areas further research should focus on in order to achieve progress in this field. This review attempts to find a paediatric cardiac surgeon's armamentarium for valve intervention, focusing on valve replacement of any of the four heart valves. The extensive literature review conducted uses online resource material from relevant medical and scientific databases, such as Medline and Science Direct.
Resource Type
DOI
Date Created
  • 2012
Former identifier
  • 948602

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