We have performed aortic valve replacement (AVR) with mechanical valve, with/without annular enlargement in pediatric patients with left ventricular outflow tract obstruction (LVOT). Twenty-two patients underwent mechanical AVR between May 1993 and December 2012. The cumulative survival rates by the Kaplan-Meier method were 95% in 5 year, and 95% in 10 year. Long-term result of mechanical AVR with/without annular enlargement in children is excellent. Therefore, it should be the 1st choice of surgical treatment at our institute. In this strategy, we had total 10 re-operation cases. Two cases:Konno operation after performing surgical aortic valvotomy, 6 cases:Konno operation after resection of subaortic stenosis, 1 case:re-valve replacement because of thrombus formation at mechanical valve, and 1 case:re-operation with somatic growth. At the age of operation, 2 years old and over cases had postoperative estimated effective orifice area index (EOAI)>0.85 cm2/m2 in the time of 20 years old. Since some issues concerning anticoagulation-related complications remain, careful observation is mandatory.
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