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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

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Published on: October 16, 2021

Outcomes and associated risk factors for mitral valve replacement in children

Bahaaldin Alsoufi1, Cedric Manlhiot, Mamdouh Al-Ahmadi

  • 1King Faisal Heart Institute, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. balsoufi@hotmail.com

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|March 1, 2011
PubMed

Insights

Mitral valve replacement (MVR) in children has high rates of death and reoperation. Patient age, prosthesis size, and complications impact outcomes, with avoiding oversized prostheses potentially improving results for younger children.

Area of Science:

  • Pediatric Cardiac Surgery
  • Cardiovascular Outcomes Research
  • Prosthetic Valve Performance

Background:

  • Mitral valve replacement (MVR) is a critical intervention for pediatric heart conditions.
  • Long-term outcomes and risk factors following MVR in children require detailed investigation.

Purpose of the Study:

  • To report time-related outcomes after MVR in a pediatric cohort.
  • To identify patient-specific and surgical factors influencing mortality and reoperation rates.

Main Methods:

  • Retrospective review of clinical records for 307 children undergoing MVR (1985-2004).
  • Application of competing-risks methodology to analyze time-to-event data for death, mitral reoperation, and survival without reoperation.
  • Identification of associated risk factors using statistical analysis.

Main Results:

  • Twenty-year predicted rates: 17% mortality, 51% mitral reoperation, 33% alive and free from reoperation.
  • Risk factors for death included younger age (<3 years), longer cross-clamp time, postoperative complications, and higher prosthesis size/BSA ratio.
  • Risk factors for reoperation included homograft/tissue prosthesis and smaller prosthesis size.

Conclusions:

  • High rates of mortality and mitral reoperation are observed post-MVR in children.
  • Outcomes are predictable based on age, prosthesis size, and other factors.
  • Optimizing prosthesis size, particularly in younger children, may improve long-term results.
Abstract

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