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Mitral valve replacement in infants and younger children
Ahmed F Elmahrouk1,2, Mohamed H Mashali3,4, Mohamed F Ismail5,6
1Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box: 40047, Jeddah, 21499, Saudi Arabia. Ael-mahrouk@kfshrc.edu.sa.
Scientific Reports
|July 28, 2021
Summary
Mitral valve replacement (MVR) in children under five has low morbidity and mortality. Reoperation risk is linked to valve size and position, not patient age.
Area of Science:
- Pediatric Cardiac Surgery
- Valvular Heart Disease
- Congenital Heart Defects
Background:
- Limited data exists on mitral valve replacement (MVR) outcomes in young children.
- Understanding factors influencing MVR success in pediatric populations is crucial for improving patient care.
- Congenital mitral valve abnormalities and associated conditions are significant causes of pediatric heart disease.
Purpose of the Study:
- To evaluate the outcomes of mitral valve replacement (MVR) in children younger than 5 years.
- To identify specific factors, such as age, valve size, and implantation position, that affect MVR outcomes in this cohort.
- To assess the long-term morbidity and mortality associated with MVR in very young children.
Main Methods:
- Retrospective analysis of 29 pediatric patients who underwent MVR between 2002 and 2020.
- Patients were categorized into two age groups: ≤24 months and >24 months.
- Data collected included primary cardiac diagnoses, hemodynamic lesions, valve types, implantation position, and follow-up events, with statistical analysis of reoperation and survival rates.
Main Results:
- The most common diagnoses were isolated congenital mitral valve abnormality (38%) and Shone complex (24%).
- Mitral regurgitation was the predominant lesion (66%).
- Valve size (SHR 0.39, P=0.02) and supra-annular position (SHR 3.1, P=0.049) significantly impacted reoperation risk, while age did not (SHR 0.89, P=0.84). No significant difference in survival was observed based on age or valve size.
Conclusions:
- Mitral valve replacement in children under five years of age is associated with favorable short-term and long-term outcomes, including low morbidity and mortality.
- The risk of reoperation after MVR in young children is influenced by prosthetic valve size and implantation position (supra-annular), rather than the patient's age.
- Further research into optimal valve selection and implantation techniques is warranted to minimize reoperation rates in pediatric MVR patients.
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