Posterior mitral leaflet extension using autologous pericardium to repair a hammock mitral valve associated with severe mitral valve regurgitation in a 4-month-old boy

Abstract

We successfully repaired a hammock mitral valve associated with severe mitral valve regurgitation in a 4-month-old boy using posterior leaflet extension along with glutaraldehyde-treated autologous pericardium and the splitting of bilateral papillary muscles. Surgical reinterventions were performed for the bilateral papillary muscles at 14 and 24 months postoperatively. The extended autologous pericardium was still pliable with mild mitral valve regurgitation at 26 months postoperatively.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. 1.

    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.

    PubMed  Article  Google Scholar 

  2. 2.

    Stellin G, Padalino M, 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;140:1238–44.

    PubMed  Article  Google Scholar 

  3. 3.

    Ohye R. Mitral regurgitation in congenital heart defects: surgical techniques for reconstruction. Semin Thorac Cardiovasc Surg Pediatr Card Surg Ann. 2012;15:75–9.

    Article  Google Scholar 

  4. 4.

    Kalfa D, Vergnat M, Ly M, Stos B, Lambert V, Baruteau A, et al. A standardized repair-oriented strategy for mitral insufficiency in infants and children: midterm functional outcomes and predictors of adverse events. J Thorac Cardiovasc Surg. 2014;148:1459–66.

    PubMed  Article  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.

    CAS  PubMed  Article  Google Scholar 

  6. 6.

    Uva MS, Galletti L, Gayet FL, Piot D, Serraf A, Bruniaux J, et al. Surgery for congenital mitral valve disease in the first year of life. J Thorac Cardiovasc Surg. 1995;109:164–76.

    CAS  PubMed  Article  Google Scholar 

  7. 7.

    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;115:84–93.

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Prifti E, Vanini V, Bonacchi M, Frati G, Bernabei M, Giunti G, et al. Repair of congenital malformations of the mitral valve: early and midterm results. Ann Thorac Surg. 2002;73:614–21.

    PubMed  Article  Google Scholar 

  9. 9.

    Delmo Walter EM, Javier M, Hetzer R. Repair of parachute and hammock valve in infants and children: early and late outcomes. Semin Thorac Cardiovasc Surg. 2016;28:448–59.

    PubMed  Article  Google Scholar 

  10. 10.

    Layman TE, Edwards JE. Anomalous mitral arcade: a type of congenital mitral insufficiency. Circulation. 1967;35:389–95.

    CAS  PubMed  Article  Google Scholar 

  11. 11.

    Okita Y, Miki S, Kusuhara K, Ueda Y, Tahata T, Tshukamoto Y, et al. Early and late results of reconstructive operation for congenital mitral regurgitation in pediatric age group. J Thorac Cardiovasc Surg. 1988;96:294–8.

    CAS  PubMed  Article  Google Scholar 

  12. 12.

    Ando M, Takahashi Y. Durability of mitral valve repair performed before the age of 5 years. Circ J. 2016;80:124–9.

    PubMed  Article  Google Scholar 

  13. 13.

    Chauvaud S, Jebara V, Chachques JC, Mihaileanu S, Perier P, Dreyfus G, et al. Valve extension with glutaraldehyde-preserved autologous pericardium. J Thorac Cardiovasc Surg. 1991;102:171–8.

    CAS  PubMed  Article  Google Scholar 

  14. 14.

    Van Loozen D, McCafferty S, Lutin WA, Polimenakos AC. The challenge of hammock mitral valve during infancy: precise preoperative advanced imaging and three-dimensional modeling augments customized operative valve reconstruction. Pediatr Cardiol. 2018;39:633–6.

    Article  Google Scholar 

  15. 15.

    Takahashi H, Kadowaki T, Maruo A, Yutaka O, Oshima Y. Mid-term results of mitral valve repair with autologous pericardium in pediatric patients. J Heart Valve Dis. 2014;23:302–9.

    PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Toshi Maeda.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Maeda, T., Fujiwara, K., Yoshizawa, K. et al. Posterior mitral leaflet extension using autologous pericardium to repair a hammock mitral valve associated with severe mitral valve regurgitation in a 4-month-old boy. Gen Thorac Cardiovasc Surg 68, 1203–1207 (2020). https://doi.org/10.1007/s11748-019-01262-9

Download citation

Keywords

  • Hammock mitral valve
  • Mitral valve regurgitation
  • Posterior leaflet extension
  • Autologous pericardium
  • Mitral valve repair