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Mitral valve replacement in children: mortality, morbidity, and haemodynamic status up to medium term follow up

C van Doorn1, R Yates, V Tsang

  • 1Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK.

Heart (British Cardiac Society)
|November 18, 2000
PubMed

Insights

Mechanical mitral valve replacement in children has eliminated structural valve failure. However, high surgical and follow-up complication rates mean it should only be used when valve repair isn't possible.

Area of Science:

  • Pediatric Cardiac Surgery
  • Mechanical Valve Prosthetics
  • Mitral Valve Replacement

Background:

  • Mechanical mitral valve replacement is a complex procedure in pediatric patients.
  • Long-term outcomes and complication rates require thorough investigation.

Purpose of the Study:

  • To evaluate the long-term outcomes of mechanical mitral valve replacement in children.
  • To assess hemodynamic status and prosthetic valve function post-surgery.

Main Methods:

  • Retrospective analysis of 54 pediatric patients undergoing mitral valve replacement (1987-1997).
  • Echocardiographic studies for hemodynamic assessment and valve function in survivors.
  • Follow-up extended up to 11 years.

Main Results:

  • 30-day mortality was 20.3%, linked to small valve size and supra-annular position.
  • Five-year actuarial freedom from death/transplantation was 68%; from bleeding 89%; from reoperation 92%.
  • Low weight, young age, and small valve size correlated with increased risk of death or reoperation. Structural valve failure was absent.

Conclusions:

  • Mechanical mitral valves in children eliminate structural valve failure concerns.
  • High complication rates persist, necessitating use only when valve repair is not feasible.
Abstract

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