Pediatric Cardiology

, Volume 29, Issue 1, pp 13–18

The Efficacy of Mitral Valve Surgery in Children with Dilated Cardiomyopathy and Severe Mitral Regurgitation

  • John P. Breinholt
  • Charles D. Fraser
  • William J. Dreyer
  • Anthony C. Chang
  • E. O’Brian Smith
  • Jeffrey S. Heinle
  • E. Dean McKenzie
  • Sarah K. Clunie
  • Jeffrey A. Towbin
  • Susan W. Denfield
Original

DOI: 10.1007/s00246-007-9050-x

Cite this article as:
Breinholt, J.P., Fraser, C.D., Dreyer, W.J. et al. Pediatr Cardiol (2008) 29: 13. doi:10.1007/s00246-007-9050-x

Abstract

Severe mitral regurgitation predicts poor outcomes in adults with left ventricular dysfunction. Frequently, adult patients now undergo initial mitral valve surgery instead of heart transplant. Pediatric data are limited. This study evaluates the efficacy of mitral valve surgery for severe mitral regurgitation in children with dilated cardiomyopathy. This is a single-institution experience in seven children (range, 0.5–10.9 years) with severe mitral regurgitation and dilated cardiomyopathy who underwent mitral valve surgery between January 1988 and February 2005, with follow-up to January 2006. Children with dilated cardiomyopathy had a depressed fractional shortening preoperatively (24.4% ± 6.1%) that remained depressed (22.9% ± 7.6%) 1.3 ± 1.2 years after surgery (p = 0.50). Left ventricular end-diastolic (6.5 ± 1.5 to 4.8 ± 1.8 z-scores, p < 0.01) and end-systolic (6.8 ± 1.5 to 5.5 ± 2.1 z-scores, p < 0.05) dimensions improved. Hospitalization frequency had a median decrease of 6.0 hospitalizations per year (p < 0.02). Three patients were transplanted 0.2, 2.4, and 3.5 years after surgery. There was no perioperative mortality. Mitral valve surgery in children with dilated cardiomyopathy was performed safely and improved symptoms, stabilizing ventricular dysfunction in most patients. Mitral valve surgery should be considered prior to heart transplant in children with dilated cardiomyopathy and severe mitral regurgitation.

Keywords

Dilated cardiomyopathyMitral regurgitationMitral valve surgery

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • John P. Breinholt
    • 1
  • Charles D. Fraser
    • 2
  • William J. Dreyer
    • 1
  • Anthony C. Chang
    • 1
  • E. O’Brian Smith
    • 1
  • Jeffrey S. Heinle
    • 2
  • E. Dean McKenzie
    • 2
  • Sarah K. Clunie
    • 1
  • Jeffrey A. Towbin
    • 1
  • Susan W. Denfield
    • 1
    • 3
  1. 1.Department of PediatricsBaylor College of Medicine and Texas Children’s HospitalHoustonUSA
  2. 2.Department of SurgeryBaylor College of Medicine and Texas Children’s HospitalHoustonUSA
  3. 3.Baylor College of MedicineHoustonUSA