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Mechanical Mitral Valve Replacement: A Multicenter Study of Outcomes With Use of 15- to 17-mm Prostheses

Rinske J IJsselhof1, Martijn G Slieker2, Kimberlee Gauvreau3

  • 1Department of Pediatric Cardiac Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.

The Annals of Thoracic Surgery
|June 12, 2020
PubMed
Abstract

Insights

Mitral valve replacement using small mechanical prostheses in infants is a viable option, demonstrating acceptable early and mid-term outcomes despite high rates of adverse events. Reintervention for outgrowth is low-risk.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Biomedical Engineering

Background:

  • Small mechanical prostheses (15-17 mm) are used for mitral valve replacement in infants.
  • Outcomes of these small prostheses require evaluation due to potential complications and reinterventions.

Purpose of the Study:

  • To assess early and mid-term outcomes, including mortality and reintervention rates, after mitral valve replacement with 15- to 17-mm mechanical prostheses in infants.

Main Methods:

  • A multicenter, retrospective cohort study involving 61 infants across 6 congenital cardiac centers.
  • Data on baseline, operative, and follow-up parameters were analyzed.

Main Results:

  • 13 in-hospital deaths (21%) and 8 late deaths (17%) occurred. Major adverse events were reported in 56% of patients.
  • 44% required prosthetic valve reintervention, primarily for outgrowth, with no reported mortality related to these procedures.

Conclusions:

  • Mitral valve replacement with 15- to 17-mm mechanical prostheses is a crucial alternative for critically ill infants unsuitable for mitral valve repair.
  • Prosthesis replacement due to outgrowth can be performed with minimal risk.

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