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Mitral Valve Replacement in Infants Using a 15-mm Mechanical Valve
Osama M Eltayeb1, William J Readdy2, Michael C Mongé1
1Division of Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
The Annals of Thoracic Surgery
|April 1, 2019
Summary
The 15-mm mechanical valve is effective for infant mitral valve replacement, with a mean replacement time of 23 months. This small valve offers a viable option for pediatric patients needing mitral valve surgery.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- The 15-mm mechanical valve, approved in March 2018, is the smallest available for pediatric mitral valve replacement.
- Infants often require mitral valve interventions due to congenital heart defects or other conditions.
Purpose of the Study:
- To review the outcomes of infants receiving the 15-mm mechanical valve in the mitral position.
- To determine the timing for repeat mitral valve replacement (MVR) in this pediatric population.
Main Methods:
- Retrospective chart review of 7 patients who underwent 8 MVRs with a 15-mm mechanical valve between 2006 and 2017.
- Analysis of short- and long-term outcomes, including operative mortality, complications, and need for re-intervention.
Main Results:
- No operative deaths occurred. Mean follow-up was 5.8 years.
- Four patients required repeat MVR due to somatic growth and patient-prosthesis mismatch, with a mean time to repeat MVR of 23 months.
- Two patients developed atrioventricular block requiring pacemaker implantation after their second MVR.
Conclusions:
- The 15-mm mechanical valve is a useful option for treating mitral valve disease in infants aged 2 to 12 months.
- The predicted mean time to replacement for this valve in the mitral position is 23 months, highlighting the need for growth-compatible solutions.
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