本文总结14岁以下儿童瓣膜替换术27例的经验。二尖瓣替换12例,三尖瓣替换11例,主动脉瓣替换4例。有合并畸形者16例(59.3%),术前Ⅱ、Ⅳ级心功能23例(85%)。13例同期修复心脏畸形。早期死亡3例(11.1%),晚期死亡4例(16.6%,4/24),再换瓣2例。本文主要经验是:对儿童换瓣应选择较大型号的机械瓣,对瓣环小的病例要改进缝合技术,机械瓣替换术后应用低强度抗凝治疗是安全可靠的。 This article summarizes the experience of valve replacement in 27 children under 14 years of age. Mitral valve replacement in 12 cases, tricuspid valve replacement in 11 cases, aortic valve replacement in 4 cases. There were 16 cases (59.3%) with deformity, and 23 cases (85%) had grade Ⅱ and Ⅳ heart function before operation. Thirteen cases of cardiac malformations were repaired. Early death in 3 cases (11.1%), late death in 4 cases (16.6%, 4/24), and then flap in 2 cases. The main experience of this paper is that we should select a larger type of mechanical valve for children with valve replacement and improve the suture technique for small valve ring. Low-intensity anticoagulant therapy after mechanical valve replacement is safe and reliable.