[Surgery for mitral regurgitation in children]

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Medical Engineering

Background:

• Mitral valve (MV) repair is preferred over replacement in pediatric patients due to avoidance of anticoagulation and suitability for small children.
• Long-term outcomes of pediatric MV repair remain incompletely understood.
• Mitral regurgitation (MR) management in pediatric populations requires further investigation.

Purpose of the Study:

• To evaluate the long-term outcomes of mitral valve repair versus replacement in pediatric patients.
• To assess reoperation rates and mitral annulus growth following MV repair.
• To identify factors influencing the success of MV repair in children.

Main Methods:

• Retrospective evaluation of 52 pediatric patients undergoing MV repair (n=46) or replacement (n=6) for MR between 1970 and 1996.
• Analysis included patients with associated diseases and those who underwent mitral annuloplasty (Kay or Paneth-Burr methods).
• Comparative assessment of reoperation-free survival and mitral annulus growth.

Main Results:

• Mitral valve repair demonstrated a significantly higher freedom from reoperation rate compared to MV replacement.
• Mitral annulus diameter showed growth within the normal range after MV repair.
• Patients with partial endocardial cushion defect (ECD) had a significantly lower freedom from reoperation rate after MV repair.

Conclusions:

• Mitral valve repair is associated with favorable long-term outcomes, including reduced reoperation rates and appropriate valve growth in pediatric patients.
• MV repair offers advantages over replacement in pediatric populations, except for those with partial endocardial cushion defects.
• Further research is warranted to optimize MV repair strategies for pediatric patients with complex cardiac conditions.