When reconstruction fails or is not feasible: valve replacement options in the pediatric population.

Valvular pathology in infants and children poses numerous challenges to the pediatric cardiac surgeon. Without question, valvular repair is the goal of intervention because restoration of valvular anatomy and physiology using native tissue allows for growth and a potentially better long-term outcome. When reconstruction fails or is not feasible, valve replacement becomes inevitable. Which valve for which position is controversial. The goal of this article is to address valve replacement options for all four valve positions within the pediatric population. We will draw from our institutional experience and review current literature to support our preferences.