Surgery Today

, Volume 44, Issue 11, pp 2086–2091 | Cite as

The early and mid-term results of mitral valve repair for mitral regurgitation in children

  • Zhaolei Jiang
  • Ju Mei
  • Fangbao Ding
  • Chunrong Bao
  • Jiaquan Zhu
  • Min Tang
  • Nan Ma
  • Jianbing Huang
  • Saie Shen
Original Article
First Online:
Received:
Accepted:

Abstract

Purpose

To review the surgical techniques and mid-term results of mitral valve repair in children with moderate or severe mitral regurgitation (MR).

Methods

One hundred and seven children with moderate or severe MR, aged 19.6 ± 8.5 months, were enrolled in this study. The surgical techniques used for mitral valve repair varied according to the mitral valve morphology, and included annuloplasty, annuloplasty ring, cleft closure, reconstruction of the posterior leaflet, etc. The concomitant cardiac anomalies were treated simultaneously. The results of repair were evaluated by transesophageal echocardiography performed during the operation and by serial transthoracic echocardiography performed during the follow-up.

Results

One hundred and six cases had no more than mild regurgitation intraoperatively, whereas only one case had moderate regurgitation. This patient underwent redo repair immediately, and the subsequent regurgitation was trivial. The in-hospital mortality rate was 0.9 % (1/107). The average follow-up was 46.5 ± 8.2 months. One patient died of heart failure 10 months postoperatively. The freedom from moderate or severe regurgitation after mitral valve repair was 92.3 ± 3.3 %.

Conclusion

Pediatric patients with moderate or severe MR require early surgical treatment. The early and mid-term results of mitral valve repair in pediatric patients were satisfactory.

Keywords

Mitral regurgitation Mitral valve repair Children 
This is a preview of subscription content, log in to check access.

Notes

Conflict of interest

The authors have no potential conflicts of interest to declare.

References

  1. 1.
    Cohn LH. Mitral valve repair. Mastery of cardiothoracic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins Inc; 2007. p. 341–52.Google Scholar
  2. 2.
    Rochae Silva A, Herdy GV, Vieira AA, Simões LC. Surgical mitral valve repair in children with rheumatic fever. Arq Bras Cardiol. 2009;92(6):400–4 (417–21, 433–8).Google Scholar
  3. 3.
    Pedrazzini GB, Faletra F, Vassalli G, Demertzis S, Moccetti T. Mitral regurgitation. Swiss Med Wkly. 2010;140(3–4):36–43.PubMedGoogle Scholar
  4. 4.
    Brizard C. Mitral valve repair in children. Mastery of cardiothoracic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins Inc; 2007. p. 1008–16.Google Scholar
  5. 5.
    Carpentier A, Branchini B, Cour JC, Asfaou E, Villani M, Deloche A, et al. Congenital malformations of the mitral valve in children. Pathology and surgical treatment. J Thorac Cardiovasc Surg. 1976;72:854–66.PubMedGoogle Scholar
  6. 6.
    Chauvaud S, Fuzellier JF, Houel R, Berrebi A, Mihaileanu S, Carpentier A. Reconstructive surgery in congenital mitral valve insufficiency (Carpentier’s techniques): long-term results. J Thorac Cardiovasc Surg. 1998;115:84–92 (discussion 92–93).PubMedCrossRefGoogle Scholar
  7. 7.
    Minich LL, Atz AM, Colan SD, Sleeper LA, Mital S, Jaggers J, et al. Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg. 2010;89(2):530–6.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Wood AE, Healy DG, Nolke L, Duff D, Oslizlok P, Walsh K. Mitral valve reconstruction in a pediatric population: late clinical results and predictors of long-term outcome. J Thorac Cardiovasc Surg. 2005;130(1):66–73.PubMedCrossRefGoogle Scholar
  9. 9.
    Shuhaiber J, Anderson RJ. Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement. Eur J Cardiothorac Surg. 2007;31:267–75.PubMedCrossRefGoogle Scholar
  10. 10.
    Beierlein W, Becker V, Yates R, Tsang V, Elliott M, de Leval M, et al. Long-term follow-up after mitral valve replacement in childhood: poor event-free survival in the young child. Eur J Cardiothorac Surg. 2007;31(5):860–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Tesler UF, Cerin G, Novelli E, Popa A, Diena M. Evolution of surgical techniques for mitral valve repair. Tex Heart Inst J. 2009;36(5):438–40.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Curi–Curi P, Ramírez-Marroquín S, Cervantes-Salazar J, Soulé M, Erdmenger J, Calderón-Colmenero J. Surgical repair of congenital mitral valve malformations. Arch Cardiol Mex. 2010;80(2):87–94.PubMedGoogle Scholar
  13. 13.
    Zias EA, Mavroudis C, Backer CL, Kohr LM, Gotteiner NL, Rocchini AP. Surgical repair of the congenitally malformed mitral valve in infants and children. Ann Thorac Surg. 1998;66(5):1551–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Oppido G, Davies B, McMullan DM, Cochrane AD, Cheung MM, d’Udekem Y, et al. Surgical treatment of congenital mitral valve disease: midterm results of a repair-oriented policy. J Thorac Cardiovasc Surg. 2008;135:1313–21.PubMedCrossRefGoogle Scholar
  15. 15.
    Stellin G, Padalino MA, Vida VL, Boccuzzo G, Orrù E, Biffanti R, et al. Surgical repair of congenital mitral valve malformations in infancy and childhood: a single-center 36-year experience. J Thorac Cardiovasc Surg. 2010;140(6):1238–44.PubMedCrossRefGoogle Scholar
  16. 16.
    Hetzer R, Delmo Walter EB, Hübler M, Alexi-Meskishvili V, Weng Y, Nagdyman N, et al. Modified surgical techniques and long-term outcome of mitral valve reconstruction in 111 children. Ann Thorac Surg. 2008;86(2):604–13.PubMedCrossRefGoogle Scholar
  17. 17.
    Sheikh KH, Bengtson JR, Rankin JS, de Bruijn NP, Kisslo J. Intraoperative transesophageal Doppler color flow imaging used to guide patient selection and operative treatment of ischemic mitral regurgitation. Circulation. 1991;84:594–604.PubMedCrossRefGoogle Scholar
  18. 18.
    Mahadin DR, Srivastava S, Parness IA, Nguyen K, Love BA, Walsh R, et al. Outcomes of mitral regurgitation associated with large ventricular septal defect and a normal mitral valve apparatus: does intact atrial septum have an impact? Pediatr Cardiol. 2011;32(8):1128–31.PubMedCrossRefGoogle Scholar
  19. 19.
    Gunther T, Mazzitelli D, Schreiber C. Mitral valve replacement in children under 6 years of age. Eur J Cardio Thorac Surg. 2000;17(4):426–30.CrossRefGoogle Scholar
  20. 20.
    Hisatomi K, Isomura T, Sato T, Kosuga K, Ohishi K, Katoh H. Mitral valve repair for mitral regurgitation with ventricular septal defect in children. Ann Thorac Surg. 1996;62(6):1773–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Berrebi A. Mitral valve repair: echocardiography is its best friend. Rev Esp Cardiol. 2011;64(7):554–6.CrossRefGoogle Scholar
  22. 22.
    Sakaguchi T, Nishi H, Miyagawa S, Yoshikawa Y, Fukushima S, Yoshioka D, et al. One-knot technique: a simple modification of the loop technique for mitral valve repair. Surg Today. 2013;43(6):705–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Aharon AS, Laks H, Drinkwater DC, Chugh R, Gates RN, Grant PW, et al. Early and late results of mitral valve repair in children. J Thorac Cardiovasc Surg. 1994;107:1262–71.PubMedGoogle Scholar
  24. 24.
    Delmo Walter EM, Hetzer R. Mitral valve repair in children. Mitral Valve Repair, II. Darmstadt, Germany: Steinkopff; 2011. p. 41–56.Google Scholar

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Zhaolei Jiang
    • 1
  • Ju Mei
    • 1
  • Fangbao Ding
    • 1
  • Chunrong Bao
    • 1
  • Jiaquan Zhu
    • 1
  • Min Tang
    • 1
  • Nan Ma
    • 1
  • Jianbing Huang
    • 1
  • Saie Shen
    • 2
  1. 1.Department of Cardiothoracic Surgery, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
  2. 2.Department of Anesthesiology, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina

Personalised recommendations