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Mitral valve replacement for children with a small annulus using ATS open pivot prosthesis.
Makoto Ando1, Yukihiro Takahashi, Toshio Kikuchi
1Department of Cardiac Surgery, The Sakakibara Heart Institute, Tokyo, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|October 8, 2003
Summary
Mitral valve replacement (MVR) using the ATS open pivot prosthesis in small children showed promising results. This surgical option is a viable choice for pediatric patients needing MVR.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Congenital heart defects often necessitate mitral valve replacement in pediatric patients.
- The ATS open pivot prosthesis is a mechanical valve used in cardiac surgery.
- Surgical outcomes in small children undergoing mitral valve replacement require careful evaluation.
Purpose of the Study:
- To review the clinical experience of mitral valve replacement (MVR) in small children using the ATS open pivot prosthesis.
- To assess the safety and efficacy of the ATS open pivot prosthesis in a pediatric population.
Main Methods:
- A retrospective review of 14 pediatric patients (mean age 1.1 years) who underwent 15 ATS mitral valve replacements between 1999 and 2002.
- Prosthesis sizes included 16AP, 18AP, and 20AP.
- Postoperative assessment included Doppler echocardiography.
Main Results:
- Four non-valve-related deaths occurred (2 early, 2 late).
- Most prostheses were oversized for the patient's age, but demonstrated normal flow velocities postoperatively.
- One patient experienced valve disc dysfunction requiring re-operation; other survivors had no morbidity.
Conclusions:
- Mitral valve replacement with the ATS open pivot prosthesis is a promising surgical option for small children.
- The prosthesis demonstrated acceptable performance in this pediatric cohort, despite some challenges with sizing.