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Surgery for mitral valvar disease in childhood: should we choose reconstruction or repair?

Ufuk Alpagut1, Enver Dayioglu

  • 1Department of Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Turkey.

Cardiology in the Young
|December 26, 2003
PubMed

Insights

Mitral valve repair in children offers a reliable surgical option with low mortality and fewer reoperations compared to valve replacement. This approach reconstructs the native valve, improving long-term outcomes for pediatric patients.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Thoracic Surgery

Background:

  • Modern surgical advancements enable mitral valve reconstruction, offering an alternative to replacement in pediatric patients.
  • Mitral valve surgery in children presents unique challenges due to growth and development.

Purpose of the Study:

  • To evaluate the outcomes of mitral valve surgery in children at a single center.
  • To compare the effectiveness of mitral valve repair versus replacement in pediatric patients.

Main Methods:

  • A retrospective review of 51 children undergoing mitral valve surgery between 1992 and 2002.
  • Surgical interventions included mitral valve repair (n=20) and valve replacement (n=31).
  • One patient received a pulmonary valve autograft for mitral valve replacement.

Main Results:

  • No early or late deaths were observed in the mitral valve repair group.
  • The mitral valve replacement group experienced no early deaths, but two late deaths occurred.
  • Six patients (19%) in the replacement group required reoperation due to prosthetic valve failure or somatic growth within 10 years.

Conclusions:

  • Mitral valve repair in children is an effective and reliable procedure with low mortality.
  • Repair procedures demonstrate a lower reoperation rate compared to mitral valve replacement in pediatric patients.
  • Reconstruction of the mitral valve is a favorable surgical strategy for children requiring intervention.
Abstract

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