Until recently, the only solution for congenital mitral and aortic valve disease was to replace the valve and replace it with an artificial valve prosthesis. Currently, the alternative to implantation is valvuloplasty, a conservative technique that seeks to preserve the valve itself.
Valvuloplasty has been developed especially in the adult population with acquired heart disease, but not in the pediatric population. This is due to the fact that the surgical technique in congenital valvulopathy in children is particularly difficult, due to the small size of the valves and the congenital pathology itself, which is always varied and very complex.
What are the risks involved in valve prosthesis implantation?
In the pediatric and adolescent population, there are several disadvantages, among which the following should be highlighted:
- Lack of valve prostheses smaller than 16 millimeters in diameter. This means that there are congenital patients who do not have access to artificial prostheses.
- Lack of growth of the prosthesis in parallel to the child’s natural weight-bearing development. Prostheses that do not grow need to be changed again (new operation) as children get older, to replace the prosthesis with a larger one.
- Need for oral anticoagulation after prosthetic valve implantation. This medication is not easily controlled in children.
Advances made by Dr. Gonzalez Rocafort
The doctor has been working intensively for ten years on congenital valve repair and advanced techniques in congenital mitral pathology in young children. The results he has obtained so far are excellent. He has achieved his two main objectives:
- Apply various craft techniques on the native valve to improve and extend the function of the valve itself for at least a few years, postponing the implantation of a valve prosthesis until adulthood.
- Apply special state-of-the-art techniques in extreme cases of mitral pathology in young children. This provides adequate valve function and quality of life to patients who would otherwise survive only a few years. These are cases in which neither valvuloplasty nor valve replacement with adequately sized commercial prostheses is possible.
He has performed these techniques on the aortic valve, with a functional result close to valvular normality and approaching ten years of follow-up.
In the mitral valve, a small group of pediatric patients with small valves and critical situations of pulmonary hypertension and heart failure, he has had great results. He has led, at national level, several avant-garde techniques of mitral replacement, achieving survival and a good quality of life.
Finally, in tricuspid valve (specifically, Ebstein’s disease), both in neonates and young children as well as in adults. The doctor has achieved a recovery that is very close to normal functionality, preserving the valve itself and avoiding a prosthetic implant. He has achieved this by applying repair techniques known as Cone plasty.
The Congenital Heart Unit and Dr. Gonzalez Rocafort will continue to be at the forefront of these techniques in order to offer the best therapeutic possibilities and achieve the best quality of life for all the children he treats.