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Congenital Mitral Regurgitation Repair Based on Carpentier's Classification: Long-Term Outcomes

Koji Miwa1, Shigemitsu Iwai1, Tomomitsu Kanaya1

  • 1Department of Cardiovascular Surgery, Osaka Women's and Children's Hospital, Osaka, Japan.

World Journal for Pediatric & Congenital Heart Surgery
|March 3, 2023
PubMed

Insights

Pediatric mitral valve repair using Carpentier

Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease
  • Valvular Heart Disease

Background:

  • Limited reports exist on standardized surgical management for mitral valve malformations based on Carpentier's classification.
  • Congenital mitral regurgitation (CMR) requires tailored surgical approaches.
  • Long-term outcomes of pediatric mitral valve repair are crucial for clinical practice.

Purpose of the Study:

  • To evaluate the long-term outcomes of mitral valve repair in pediatric patients.
  • To analyze repair success rates stratified by Carpentier's classification of mitral valve lesions.
  • To assess freedom from mitral valve replacement and reoperation post-repair.

Main Methods:

  • Retrospective review of 23 pediatric patients undergoing mitral valve repair (2000-2021).
  • Analysis of preoperative data, surgical techniques, and outcomes categorized by Carpentier's classification.
  • Kaplan-Meier analysis to estimate freedom from mitral valve replacement and reoperation.

Main Results:

  • Follow-up of 10 years (median age 4 months) with no operative mortality.
  • Overall 5-year freedom from mitral valve replacement was 91%.
  • Five-year freedom from reoperation ranged from 67% (Type 4) to 80% (Type 2) based on Carpentier's classification.

Conclusions:

  • Standardized surgical management for congenital mitral regurgitation yields favorable long-term outcomes.
  • Complex mitral valve lesions (Carpentier types) may necessitate combined surgical techniques for successful repair.
  • Mitral valve repair in children demonstrates good durability, with low rates of reoperation and replacement.
Abstract

Keywords:
Carpentier's classificationchildrencongenital mitral valve regurgitationinfantlong-term surgical outcomemitral valve malformationmitral valve repair

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