• Jolanda Kluin, David R Koolbergen, Vladimir Sojak, and Mark G Hazekamp.
• Department of Cardiothoracic Surgery, Leiden University Center, Leiden, Netherlands Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, Netherlands.
• Eur J Cardiothorac Surg. 2016 Sep 1; 50 (3): 476-81.

ObjectivesIn children, words of caution have been raised about valve-sparing procedures especially regarding the valve-remodelling technique. This study reviewed our experience with the valve-sparing reimplantation technique in children.MethodsAll consecutive paediatric (<18 years) patients who underwent valve-sparing root replacement in our centre in the past 12.5 years were retrospectively analysed.ResultsNineteen patients (median age 13.2 years, 10 months to 17.9 years) underwent valve-sparing root replacement using the reimplantation technique. Seventeen had connective tissue disease. An adult-sized vascular prosthesis could be implanted in all cases. Additional cusp repair was required in 3 patients. Follow-up was 4.4 ± 3.8 years. There was no perioperative mortality and one late death. Of the 3 patients that needed cusp repair, 1 developed Grade 3 aortic valve regurgitation (AR) and required aortic valve replacement and 2 had Grade 1 AR. Ninety-four percent of the other patients had Grade 0 AR at latest follow-up, 1 patient (6%) had Grade 1 AR.ConclusionsOur data show that valve-sparing root surgery using the reimplantation technique can be performed safely in children. Mid-term follow-up yields stable and favourable results. When leaflet reconstruction is necessary on top of the reimplantation procedure, rate of recurrent AR seems to be higher.© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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