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Updated: Jun 20, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Long-term results after mitral valve repair in children
Cheul Lee1, Chang-Ha Lee, Jae Gun Kwak
1Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Sosa-gu, Bucheon, Kyungki-do 422-232, Republic of Korea. tscheul@hanmail.net
Insights
Mitral valve repair in children offers excellent survival rates and good long-term valve function. While re-operation is sometimes needed, successful re-repair is common, ensuring positive outcomes for pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Valvular Heart Disease
Background:
- Mitral valve (MV) repair in pediatric patients is a complex procedure.
- Long-term outcomes and risk factors for re-operation require further investigation.
Purpose of the Study:
- To analyze the long-term results of mitral valve repair in children.
- To identify risk factors associated with re-operation and assess overall survival.
Main Methods:
- Retrospective review of 139 children (<18 years) who underwent MV repair between 1988 and 2007.
- Exclusion of specific congenital heart defects; detailed analysis of mitral regurgitation (MR) and mitral stenosis (MS) prevalence.
- Assessment of surgical techniques, re-operations, replacements, survival rates, and echocardiographic findings during follow-up.
Main Results:
- No early deaths; 15-year survival rate of 97%.
- 77% freedom from MV re-operation and 90% from MV replacement at 15 years.
- Significant improvement in MR and MS severity post-repair; all survivors in NYHA class I or II.
Conclusions:
- Pediatric mitral valve repair demonstrates excellent long-term survival and satisfactory valve function.
- Residual mitral valve dysfunction is a key risk factor for re-operation, with successful re-repair in over half of cases.
- Mitral valve repair is a viable and effective treatment for selected pediatric patients with valvular heart disease.
Objective:
We analysed the long-term results of mitral valve (MV) repair in children.
Methods:
We reviewed clinical records of 139 children (<18 years) who underwent MV repair between 1988 and 2007. Patients with atrioventricular septal defect, single ventricle or atrioventricular discordance were excluded. Median age was 2.3 years (2 months to 17.6 years), and 47 children (34%) were infants. Mitral regurgitation (MR) was predominant in 125 patients (90%), and 91 (73%) of these showed MR grade > or = 3. Mitral stenosis (MS) was predominant in 14 patients (10%), and median mean pressure gradient across the MV was 9.0 mmHg (0-20 mmHg). Associated cardiac lesions were present in 111 patients (80%) and were addressed concurrently in 105 patients. Various surgical techniques were used according to the functional and pathologic findings of MV.
Results:
There was no early death. Median follow-up was 8 years (2 months to 20 years, 78% complete). Twenty-six patients required 29 MV re-operations, and 11 of these required MV replacements. At 15 years, freedom from MV re-operation and MV replacement was 77% and 90%, respectively. Diagnosis of MS and MV status on discharge (MR grade > or =3 or MS gradient > or =10 mmHg) were significant risk factors for re-operation. There were three late deaths, and the overall survival was 97% at 15 years. Among 122 survivors with MR, 102 patients (84%) underwent echocardiography during follow-up. The degree of MR decreased significantly and only five patients showed MR grade 3. Among 14 survivors with MS, eight patients (57%) underwent echocardiography during follow-up. The degree of MS decreased significantly and median MS gradient was 2.8 mmHg (0-10 mmHg). All survivors remain in the NYHA class I or II.
Conclusions:
MV repair in children showed excellent survival, acceptable re-operation rate and satisfactory valve function at long-term follow-up. Residual MV dysfunction was a significant risk factor for re-operation, but re-repair was successful in more than half of the patients who underwent re-operation.
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