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Mitral valve replacement in children.

H Raffa1, H Al Khateeb, T Tunisi

  • 1Department of Cardiac Surgery, Saudi Heart Centre, Jeddah, Saudi Arabia.

The Australian and New Zealand Journal of Surgery
|August 1, 1988
PubMed
Summary

Rheumatic heart disease remains a significant issue in developing nations, necessitating valve surgery in children. Mitral valve replacement in 75 children showed a 9.3% operative mortality and an 87% 5-year survival rate.

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Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Valvular Heart Disease

Background:

  • Rheumatic fever is a common cause of advanced valvular heart disease in children globally.
  • Developing countries face a high incidence of rheumatic heart disease requiring surgical intervention.

Purpose of the Study:

  • To review the outcomes of mitral valve replacement in pediatric patients.
  • To evaluate the efficacy of different prosthetic valves in children with rheumatic heart disease.

Main Methods:

  • Retrospective review of 75 children undergoing mitral valve replacement between 1981-1987.
  • Analysis of valve types (bovine pericardial vs. mechanical bi-leaflet) and patient outcomes.
  • Assessment of etiology, functional class, and operative findings.

Main Results:

  • Rheumatic etiology was predominant (71/75 children).
  • 85% of children were in NYHA functional class III or IV pre-operatively.
  • Operative mortality was 9.3%, with a 5-year actuarial survival rate of 87%.

Conclusions:

  • Mitral valve replacement is a viable option for children with advanced rheumatic heart disease.
  • Both bovine pericardial and mechanical valves demonstrated acceptable survival rates in this pediatric cohort.
  • Continued vigilance and treatment of rheumatic fever are crucial in affected regions.

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