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Age less than two years is not a risk factor for mortality after mitral valve replacement in children

Daniela Y Rafii1, Ryan R Davies, Sheila J Carroll

  • 1Division of Pediatric Cardiology and Cardiothoracic Surgery at Columbia University College of Physicians and Surgeons, New York, New York, USA.

The Annals of Thoracic Surgery
|March 29, 2011
PubMed

Insights

Mitral valve replacement (MVR) in children under 2 years old showed similar survival rates to older children. However, younger patients faced a higher risk of reoperation after MVR.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Thoracic Surgery

Background:

  • Mitral valve replacement (MVR) outcomes in pediatric patients, especially those under 2 years old, are often poor.
  • This study compares long-term morbidity and mortality of MVR in two pediatric age groups: under 2 years and 2 to 18 years.

Purpose of the Study:

  • To compare long-term morbidity and mortality associated with mitral valve replacement (MVR) in pediatric patients.
  • To assess survival rates, reoperation needs, and adverse events in different pediatric age groups undergoing MVR.

Main Methods:

  • Retrospective evaluation of pediatric patients undergoing MVR between March 1990 and November 2007.
  • Comparison of morbidity and mortality between patients under 2 years old and those aged 2 to 18 years.
  • Primary endpoints included postoperative and long-term survival, reoperation, cerebrovascular events, and bleeding.

Main Results:

  • Forty-five patients underwent 54 MVRs; 18 patients were under 2 years old.
  • No significant difference in short-term or long-term survival between the two age groups (10-year survival: 82% younger vs. 85% older).
  • Significantly higher freedom from reoperation in older patients (96% at 10 years) compared to younger patients (40% at 10 years), p = 0.003.

Conclusions:

  • Pediatric patients under 2 years old undergoing MVR demonstrated comparable survival rates to older children.
  • Age under 2 years is identified as a risk factor for reoperation but not for mortality after MVR in this cohort.
  • MVR in very young children requires careful consideration due to increased reoperation risk.
Abstract

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