Mitral Valve Replacement in Infants and Children: Experience Using a 15-mm Mechanical Valve

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Limited reports exist on the use of 15-mm mechanical valves for mitral valve replacement (MMVR) in pediatric patients.
• This study reviews the operative and postoperative outcomes of MMVR using a 15-mm mechanical valve at a single center.

Purpose of the Study:

• To evaluate the short- and long-term outcomes of 15-mm mechanical mitral valve replacement in a pediatric population.
• To assess the safety, efficacy, and durability of this device in children.

Main Methods:

• A retrospective chart review was conducted for patients who underwent MMVR between 2009 and 2022.
• Data on operative details, postoperative recovery, adverse events, and long-term outcomes were analyzed using descriptive statistics.

Main Results:

• Fifteen patients underwent 16 MMVRs with no operative deaths. Median age was 6.2 months; median weight was 5.16 kg.
• Postoperative recovery was rapid, with a median intubation duration of 1.5 days and hospital length of stay of 17 days.
• Major adverse events occurred in 20% of patients, and 31% required readmission for anticoagulation management. Device durability was observed, with 6 patients having the original valve at a median of 4.7 years.

Conclusions:

• The 15-mm MMVR in children demonstrates a lower rate of major adverse events and good device durability compared to previous reports.
• Rapid postoperative recovery was noted, but challenges remain in achieving consistent anticoagulation in this pediatric cohort.
• This single-center experience provides valuable insights into the use of small mechanical mitral valves in pediatric patients.