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Mitral valve replacement in children

D G Human, H S Joffe, C B Fraser

    The Journal of Thoracic and Cardiovascular Surgery
    |June 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    Mitral valve replacement in children shows excellent early results, but long-term durability of heterograft valves is a concern. Mechanical valves offer better event-free survival compared to bioprosthetic options.

    Area of Science:

    • Cardiovascular Surgery
    • Pediatric Cardiology
    • Biomaterials Science

    Background:

    • Mitral valve replacement (MVR) in pediatric patients historically presents higher risks than in adults.
    • Heterograft valves have been favored for pediatric MVR due to perceived lower risks.
    • This study evaluates the outcomes of MVR in children using various prosthetic valves.

    Purpose of the Study:

    • To assess the early and late outcomes of mitral valve replacement in children.
    • To compare the performance of mechanical versus heterograft prosthetic valves in pediatric patients.
    • To evaluate the long-term durability and complication rates associated with different valve types.

    Main Methods:

    • Retrospective review of 56 pediatric patients (ages 2-12) undergoing MVR between 1972 and 1979.

    Related Experiment Videos

  • Analysis of valve etiology, NYHA functional class, and cardiac catheterization findings.
  • Comparison of outcomes based on implanted prosthetic valve type: Starr-Edwards, Lillehei, Björk-Shiley, Hancock, and Carpentier-Edwards.

    • Main Results:

    • Operative mortality was 2%, with overall late mortality at 10%.
    • Serious late complications occurred in 30% of survivors, predominantly calcific stenosis in heterografts.
    • Survival rates at 5 years were 92% for heterografts and 77% for mechanical valves.
    • Event-free survival at 5 years was significantly higher for mechanical valves (84%) compared to heterografts (10%).

    Conclusions:

    • Early operative results for pediatric MVR are favorable, with overall mortality comparable to adult MVR.
    • Long-term durability remains a significant issue, particularly for heterograft valves, with less than 10% surviving beyond 5 years.
    • Mechanical valves demonstrate superior long-term event-free survival in pediatric mitral valve replacement compared to heterografts.