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. 2024 Oct 1:11:1454649.
doi: 10.3389/fcvm.2024.1454649. eCollection 2024.

Long-term outcomes of mitral valve repair in children

Osman Nuri Tuncer  1 , Serkan Ertugay  1 , Mahsati Akhundova  1 , Ertürk Levent  2 , Yüksel Atay  1
Affiliations

Long-term outcomes of mitral valve repair in children

Osman Nuri Tuncer et al. Front Cardiovasc Med. .

Abstract

Background: Mitral Valve Disease in children presents unique challenges due to the wide range of associated pathologies and the complexities of pediatric cardiac anatomy. Mitral valve repair in this demographic is preferred over replacement due to the drawbacks associated with prosthetic valves in young patients, such as the need for long-term anticoagulation and issues with prosthetic size and growth.

Methods: This retrospective study reviewed pediatric patients under 18 years who underwent mitral valve repair between January 2002 and December 2023. Exclusion criteria included patients with atrioventricular septal defects or single-ventricle physiology. Surgical outcomes were assessed using preoperative and postoperative transthoracic echocardiography, with follow-up data analyzed via Kaplan-Meier survival estimates.

Results: The study included 47 patients with a median age of 4 years. Surgical techniques varied based on the specific mitral valve pathology. The overall early mortality was 6.3%, and the one and ten-year survival rates were 93.6 ± 3.6% and 91.4 ± 4.1%, respectively. Most patients showed improved or stable postoperative cardiac function during a median follow-up of 105 months. Notably, the rate of freedom from re-operation at ten years was 85.1 ± 6.9%, highlighting the durability of the surgical interventions.

Conclusions: Mitral valve repair in children demonstrates favorable long-term outcomes with low mortality and reoperation rates, particularly when performed at an older age to accommodate growth and avoid the complexities of smaller, more delicate cardiac structures. These findings suggest that mitral valve repair should be considered a viable and effective option for managing pediatric MVD, with a personalized approach essential for optimizing outcomes.

Keywords: cardiac surgical procedures; congenital heart disease; mitral regurgitation; mitral stenosis (MS); mitral valve annuloplasty.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier curves showing overall survival.
Figure 2
Figure 2
Kaplan-Meier curves showing freedom from re-operation due to MVD.
See this image and copyright information in PMC

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