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Mitral Valve Repair in Children Below Age 10 Years: Trouble or Success?
Benedikt Mayr1, Keti Vitanova2, Melchior Burri2
1Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany; Department of Pediatric and Congenital Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.
Insights
Mitral valve (MV) repair in children under 10 is effective for mitral valve disease (MVD). However, this procedure often postpones the need for eventual valve replacement in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Congenital Heart Disease
Background:
- Mitral valve (MV) repair in pediatric patients presents unique challenges due to diverse pathologies and growth considerations.
- Surgical outcomes for MV repair in young children require thorough evaluation.
Purpose of the Study:
- To assess the effectiveness and outcomes of mitral valve repair in children under 10 years of age.
- To evaluate survival rates and reoperation incidence following MV repair in this pediatric cohort.
Main Methods:
- Retrospective review of all mitral valve repair procedures in children under 10 years old.
- Analysis of survival and cumulative incidence of reoperation as primary endpoints.
Main Results:
- Mitral valve repair was performed in 50 children (40 congenital, 10 acquired MV disease).
- Operative mortality was 5% and late mortality 10% for congenital MV disease; no deaths occurred in acquired MV disease.
- Six-year reoperation incidence was 38.6% ± 8.3% in congenital MV disease patients.
Conclusions:
- Mitral valve repair serves as a viable treatment for pediatric MV disease in children under 10.
- While effective, MV repair in this age group frequently necessitates future valve replacement.
Background:
Mitral valve (MV) repair in children is challenging because of the broad spectrum of lesions and anticipated patient growth. The purpose of the study was to evaluate the outcome of MV repair in children below 10 years of age.
Methods:
We reviewed all MV repair procedures performed in children below 10 years of age. Endpoints of the study were survival after MV repair and cumulative incidence of reoperation.
Results:
MV repair was performed in 40 patients with congenital MV disease (MVD) and in 10 patients with acquired MVD. Median age at time of repair for congenital MVD was 1.2 years (range, 14 days to 9.8 years) and for acquired MVD 1.9 years (range, 10 days to 9.9 years). Indication for MV repair was mitral regurgitation in 31 congenital MVD patients (77.5%) and in all acquired MVD patients. In patients with congenital MVD operative mortality was 5% and late mortality was 10%. No deaths occurred in patients with acquired MVD. Patients with congenital mitral regurgitation showed a better, yet not significant, 6-year survival than patients with congenital mitral stenosis (85.3% ± 8.2% vs 60% ± 18.2%, P = .1). In patients with congenital MVD cumulative incidence of reoperation at 6 years was 38.6% ± 8.3%.
Conclusions:
In children below 10 years of age, MV repair is an effective treatment option for MVD. However it often just delays the time to valve replacement.
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