Related Experiment Video

Updated: Feb 25, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

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Preoperative echocardiographic predictors of mitral valve repair failure in children

Yue Gao1, Xinjie Lin2, Qiyu He2

  • 1Department of Echocardiography, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Beilishilu, Xicheng District, Beijing, 100037, China.

European Journal of Pediatrics
|February 23, 2026
PubMed

Insights

Pediatric mitral valve repair failure is predicted by underdeveloped chordae tendineae and a dilated mitral annulus (MVAI > 8.73 cm²/m²). These echocardiographic findings aid in risk stratification for better surgical outcomes.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Mitral valve (MV) repair in pediatric patients with mitral regurgitation (MR) is complex and has unpredictable outcomes.
  • Identifying preoperative predictors of MV repair failure is crucial for improving surgical success rates in children.

Purpose of the Study:

  • To identify preoperative echocardiographic predictors of MV repair failure in pediatric patients with MR grade ≥ 2.
  • To assess the role of MV morphology and annulus dimensions in predicting repair outcomes.

Main Methods:

  • Retrospective review of 309 pediatric patients undergoing MV repair (January 2019 - July 2024).
  • Assessment of MV morphology and parameters using 2D and 3D echocardiography.
  • Definition of MV repair failure as a composite of postoperative functional failure, heart transplantation, or death.

Main Results:

  • MV repair failure occurred in 11.97% of cases during a median follow-up of 6.93 months.
  • Underdeveloped chordae tendineae (HR=3.69) and elevated mitral valve annulus area index (MVAI) (HR=1.23) were independent predictors of MV repair failure.
  • A MVAI exceeding 8.73 cm²/m² was a significant threshold for predicting failure, especially in isolated MR.

Conclusions:

  • Underdeveloped chordae tendineae and a significantly dilated mitral annulus (MVAI > 8.73 cm²/m²) are key preoperative echocardiographic predictors of MV repair failure in pediatric patients with MR grade ≥ 2.
  • These findings can aid in risk stratification and inform surgical timing for pediatric MV repair.

Keywords:
Echocardiographic predictorsMitral repair failurePediatric patients

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