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Debate - Replacement of the Mitral Valve Under One Year of Age: Mechanical Valves Should Be Used

David G Lehenbauer1, James S Tweddell1, David S Winlaw1

  • 1Heart Institute and Department of Surgery, and the Division of Cardiothoracic Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
|June 12, 2021
PubMed

Insights

Pediatric mitral valve replacement in infants under 1 year old has the highest mortality and poorest long-term outcomes. This review focuses on recent literature to guide valve selection and surgical techniques for neonatal and infant cases.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Medical Literature Review

Background:

  • Mitral valve replacement in children younger than 1 year of age is a critical procedure.
  • This patient group faces the highest mortality and poorest long-term prognosis compared to other pediatric valve replacements.
  • Recent advancements necessitate a review of current practices.

Purpose of the Study:

  • To review the latest literature on mitral valve replacement in infants.
  • To provide insights into optimal valve choice and surgical techniques for neonatal and infant mitral valve replacement.
  • To highlight the challenges and outcomes associated with this high-risk procedure.

Main Methods:

  • Comprehensive literature search focusing on publications from the third millennium.
  • Analysis of studies reporting on mitral valve replacement in children younger than 1 year.
  • Special emphasis on neonatal and infant cases.

Main Results:

  • Identification of key trends and outcomes in infant mitral valve replacement.
  • Evaluation of different prosthetic valve options and their suitability for neonates and infants.
  • Analysis of surgical techniques and their impact on patient prognosis.

Conclusions:

  • Mitral valve replacement in infants remains a high-risk procedure with significant challenges.
  • Careful consideration of valve prosthesis and surgical technique is crucial for improving outcomes.
  • Further research is needed to optimize long-term results in this vulnerable population.

Keywords:
Bioprosthetic mitral valve replacementMechanical mitral valveOutcome measuresPediatric mitral valve replacementTranscatheter mitral valve replacement

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