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Mitral valve replacement in children.

Eldad Erez1, Kirk R Kanter, Elizabeth Isom

  • 1Division of Cardio-Thoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

The Journal of Heart Valve Disease
|February 13, 2003
PubMed
Summary

Mitral valve replacement (MVR) is a viable surgical option for children over 2 years old with non-repairable mitral valves. However, MVR after failed atrioventricular septal defect repair in younger children carries significant risks.

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Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Congenital Heart Disease

Background:

  • Mitral valve repair in children has improved but is not always successful.
  • Mitral valve replacement (MVR) is an alternative for non-repairable valves.

Purpose of the Study:

  • To review a 20-year experience with mitral valve replacement (MVR) in pediatric patients.
  • To evaluate outcomes and identify risk factors associated with MVR in children.

Main Methods:

  • Retrospective review of 90 pediatric patients undergoing 102 MVR operations from 1980 onwards.
  • Analysis of patient demographics, etiology of valve disease, surgical procedures, and outcomes.

Main Results:

  • Hospital mortality was significantly higher in children under 2 years old (52%) compared to older children (3%).

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  • Major late events included bleeding, thromboemboli, and cardiomyopathy requiring heart transplantation.
  • Failed atrioventricular septal defect (AVSD) repair followed by MVR in young children was associated with high morbidity and mortality.

    • Conclusions:

    • Mitral valve replacement (MVR) is a suitable surgical choice for children over 2 years with irreparable mitral valves.
    • MVR in children under 2 years, especially after failed AVSD repair, is associated with substantial risks and should be carefully considered.