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Predictores ecocardiográficos preoperatorios de la falla en la reparación de la válvula mitral en niños

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

Resumen

El fallo de la reparación de la válvula mitral pediátrica se predice por chordae tendineae subdesarrollados y un anillo mitral dilatado (MVAI > 8,73 cm2/m2). Estos hallazgos ecocardiográficos ayudan en la estratificación del riesgo para mejores resultados quirúrgicos.

Área de la Ciencia:

Cardiología Pediátrica Cardiología pediátrica.
Cirugía cardíaca Cirugía cardíaca.
La ecocardiografía es una ecocardiografía.

Sus antecedentes:

La reparación de la válvula mitral (MV) en pacientes pediátricos con regurgitación mitral (MR) es compleja y tiene resultados impredecibles.
La identificación de predictores preoperatorios del fracaso de la reparación de MV es crucial para mejorar las tasas de éxito quirúrgico en niños.

Objetivo del estudio:

Identificar los predictores ecocardiográficos preoperatorios de la falla de la reparación de MV en pacientes pediátricos con grado de MR ≥ 2.
Evaluar el papel de la morfología de MV y las dimensiones del anillo en la predicción de los resultados de la reparación.

Principales métodos:

Revisión retrospectiva de 309 pacientes pediátricos sometidos a reparación de MV (enero de 2019 - julio de 2024).
Evaluación de la morfología y parámetros de MV utilizando ecocardiografía 2D y 3D.
Definición de la falla de reparación de MV como un compuesto de insuficiencia funcional postoperatoria, trasplante de corazón o muerte.

Principales resultados:

El fallo en la reparación de MV se produjo en el 11,97% de los casos durante un seguimiento mediano de 6,93 meses.
Los chordae tendineae subdesarrollados (HR = 3.69) y el índice elevado del área del anillo de la válvula mitral (MVAI) (HR = 1.23) fueron predictores independientes de la falla de reparación de la válvula mitral.
Un MVAI superior a 8,73 cm2/m2 fue un umbral significativo para predecir el fallo, especialmente en MR aislado.

Conclusiones:

Los chordae tendineae subdesarrollados y un anillo mitral significativamente dilatado (MVAI > 8,73 cm2 / m2) son predictores ecocardiográficos preoperatorios clave del fracaso de la reparación de MV en pacientes pediátricos con grado MR ≥ 2.
Estos hallazgos pueden ayudar en la estratificación del riesgo e informar el calendario quirúrgico para la reparación pediátrica de MV.

Palabras clave:

Los predictores de la ecocardiografía son predictores de la ecocardiografía.El fallo en la reparación de la mitral.Pacientes pediátricos en los pacientes pediátricos.

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