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Mitral valve repair with artificial chordae replacement in children: a single-center experience

Yaojun Dun1, Jiayi Xing2, Dong Zhao1

  • 1Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167# Beilishi Road, Xicheng District, Beijing, 100037, China.

General Thoracic and Cardiovascular Surgery
|March 3, 2021
PubMed

Insights

Mitral valve repair using artificial chordae in children shows acceptable outcomes, particularly for simple lesions and older children. Long-term success is promising, with specific patient groups demonstrating better results.

Area of Science:

  • Pediatric cardiology
  • Cardiac surgery
  • Biomaterials in medicine

Background:

  • Mitral valve (MV) disease in children can lead to significant morbidity.
  • Surgical repair, including artificial chordae replacement, is an option for pediatric MV disease.
  • Understanding outcomes of this specific repair technique in children is crucial for clinical decision-making.

Purpose of the Study:

  • To evaluate the early and intermediate outcomes of mitral valve repair with artificial chordae replacement in pediatric patients.
  • To identify factors influencing the success of this surgical technique in children.

Main Methods:

  • Retrospective review of pediatric patients (<18 years) undergoing MV repair with artificial chordae replacement from 2011-2019.
  • Kaplan-Meier analysis and log-rank testing to estimate freedom from MV reoperation and dysfunction.
  • Stratification of patients based on lesion complexity (simple vs. complex) and age (<12 vs. >12 years).

Main Results:

  • Thirty pediatric patients were analyzed, with 15 having simple and 15 complex lesions.
  • At 36 months follow-up, freedom from MV reoperation was 91.3% at 5 and 8 years.
  • Freedom from MV dysfunction at 5 years was 61.8%, with significantly better outcomes in simple lesions (100%) and older children (>12 years, 90.0%).

Conclusions:

  • Mitral valve repair with artificial chordae replacement offers acceptable early and intermediate outcomes in children.
  • Outcomes are significantly better for pediatric patients with simple mitral valve lesions.
  • Older children (over 12 years) also experience more favorable results with this repair technique.
Abstract

Keywords:
Artificial chordaeChildrenMitral regurgitationMitral valve repair

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