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Outcomes of mitral valve replacement with bileaflet mechanical prosthetic valve in children

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Abstract

Objectives

We examined the outcomes following mitral valve replacement with bileaflet mechanical prosthetic valve in children and identified the predictors for mortality and reoperation.

Methods

Medical records from 49 children who underwent mitral valve replacement between 1982 and 2015 were reviewed retrospectively. Median age and body weight at initial mitral valve replacement were 2.4 years and 9.7 kg, respectively. The median follow-up was 13 years. Surgical results and predictors for mortality and reoperation were investigated.

Results

There was no operative mortality; eight late deaths occurred. The actuarial survival rates were 89.5%, 84.2%, and 80.7% at 5, 10, and 15 years, respectively, after initial mitral valve replacement. The actuarial freedom rates from related complications were 89.5%, 78.3%, and 70.7% at 5, 10, and 15 years, respectively. Nineteen patients required 1st re-mitral valve replacement at a median of 5.9 years; six of these 19 required 2nd re-mitral valve replacement at a median of 8.9 years after 1st re-MVR. The actuarial freedom rates from re-mitral valve replacement were 86.0%, 56.8%, and 44.2% at 5, 10, and 15 years, respectively. No predictor for death was determined; however, the predictor for re-mitral valve replacement was initial valve diameter less than 19 mm.

Conclusions

Survival outcomes among children after mitral valve replacement with bileaflet mechanical prosthetic valve in biventricular heart were satisfactory. However, complications, including re-mitral valve replacement, were frequent and the predictor was of a small prosthesis size.

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Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Fukuoka Children’s Hospital, 5-1-1 Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan

    Takuya Okamoto, Toshihide Nakano, Masami Goda, Shinichiro Oda & Hideaki Kado

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  1. Takuya Okamoto
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  2. Toshihide Nakano
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  3. Masami Goda
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  4. Shinichiro Oda
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  5. Hideaki Kado
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Correspondence to Takuya Okamoto.

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Okamoto, T., Nakano, T., Goda, M. et al. Outcomes of mitral valve replacement with bileaflet mechanical prosthetic valve in children. Gen Thorac Cardiovasc Surg 68, 571–577 (2020). https://doi.org/10.1007/s11748-019-01236-x

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  • DOI: https://doi.org/10.1007/s11748-019-01236-x

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