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Durability of Mitral Valve Repair Performed Before the Age of 5 Years

Makoto Ando1, Yukihiro Takahashi

  • 1Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute.

Circulation Journal : Official Journal of the Japanese Circulation Society
|November 17, 2015
PubMed

Insights

Mitral valve repair in children under five is feasible, showing excellent survival rates and acceptable reoperation incidence. This pediatric cardiac surgery offers a viable solution for young patients with mitral valve disease.

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Valvular Heart Disease

Background:

  • Mitral valve repair in adults is challenging in young children due to anatomical and tissue limitations.
  • Pediatric patients present unique challenges for mitral valve repair, including small annulus size, growth potential, and fragile tissue.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of mitral valve repair in patients younger than 5 years.
  • To assess survival rates, reoperation rates, and the degree of mitral regurgitation after repair in this pediatric population.

Main Methods:

  • Retrospective analysis of 51 patients under 5 years old who underwent mitral valve repair between 1980 and 2011.
  • Utilized various repair techniques including commissural annuloplasty, edge-to-edge repair, commissural closure, accessory cleft closure, sliding leaflet, and artificial/shortened chordae.
  • Median follow-up was 3.0 years (maximum 24.2 years).

Main Results:

  • Excellent actuarial survival rates were achieved: 97.0±3.0% for isolated mitral regurgitation and 85.1±9.7% for those with other congenital heart disease.
  • Postoperative mitral regurgitation was mild or less in 80.4% of patients (41/51).
  • 9 patients required reoperation; 10-year freedom from reoperation was 91.7±68.0% for isolated cases and 68.4±9.4% for complex cases.

Conclusions:

  • Mitral valve repair in patients younger than 5 years yields excellent survival outcomes.
  • The rates of reoperation and significant mitral regurgitation following repair in this young cohort are acceptable.
Abstract

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