Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-18T01:13:36.119Z Has data issue: false hasContentIssue false
  • English
  • Français

Surgery for mitral valvar disease in childhood: should we choose reconstruction or repair?

Published online by Cambridge University Press:  24 May 2005

Ufuk Alpagut  and
Enver Dayioglu
Ufuk Alpagut
Affiliation:
Department of Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Turkey
Enver Dayioglu
Affiliation:
Department of Cardiovascular Surgery, Istanbul Medical Faculty, Istanbul University, Turkey
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: Modern surgical techniques now offer the potential for reconstructing rather than replacing the mitral valve in those patients who require an operation during childhood. The purpose of this study was to assess the outcome in our centre following mitral valvar surgery in children. Methods: Between 1992 and 2002, 51 consecutive children, with a mean age of 12.5 ± 3.5 years, underwent surgical treatment of mitral valvar stenosis and/or insufficiency in the Cardiovascular Surgical Department of Istanbul University. Of the children, 20 underwent repair, whilst we replaced the valve in 31 patients. In one, we inserted a pulmonary valvar autograft in mitral position. Results: There were neither early nor late deaths in those who underwent mitral valvar repair. Similarly, there were no early deaths in those in whom the valve was replaced, but two patients died late, while six outgrew their prosthetic valves and required insertion of a further valve within 10 years of their first operations. Conclusion: Our experience shows that procedures designed to repair the mitral valve are effective and reliable when performed in children, with low mortality, and a lower incidence of reoperation when compared with those having replacement of the mitral valve.

Keywords

Atrioventricular valvepediatricsreoperationannuloplasty
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 4 , August 2003 , pp. 337 - 340
Copyright
© 2003 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Davachi F, Moller JH, Edwards JE. Diseases of the mitral valve in infancy. Circulation 1971; 43: 565.Google Scholar
Carpentier A, Branchini B, Cour JC, et al. Congenital malformations of the mitral valve in children: pathology and surgical treatment. J Thorac Cardiovasc Surg 1976; 72: 854–866.Google Scholar
Aharon AS, Laks H, Drinkwater DC, et al. Early and late results of mitral valve repair in children. J Thorac Cardiovasc Surg 1994; 107: 1262–1271.Google Scholar
Oosthoek PW, Wennink ACG, Wisse LJ, Gittenberger-de Groot AC. Development of the papillary muscles of the mitral valve: morphogenetic background of parachute like asymmetric mitral valves and other mitral valve anomalies. J Thorac Cardiovasc Surg 1998; 116: 36–46.Google Scholar
Okita Y, Miki S, Kusuhara K, et al. Early and late results of reconstructive operation for congenital mitral regurgitation in pediatric age group. J Thorac Cardiovasc Surg 1988; 96: 294–298.Google Scholar
Stellin G, Bortolotti U, Mazzucco A, et al. Repair of congenitally malformed mitral valve in children. J Thorac Cardiovasc Surg 1988; 95: 480–485.Google Scholar
Collins Nakai RL, Rosenthal A, Castaneda AR, Bernhard NF, Nadeo AS. Congenital mitral stenosis. A review of 20 years' experience. Circulation 1977; 56: 1039–1047.Google Scholar
Moore P, Adatia I, Spevak PJ, et al. Severe congenital mitral stenosis in infants. Circulation 1994; 89: 2099–2106.Google Scholar
Embrey RP, Behrendt DM. Congenital abnormalities of the mitral valve. In: Baue AE (ed.). Glenn's Thoracic and Cardiovascular Surgery, 6th edn, Volume II, Appleton & Lange, Stamford, Connecticut, 1996, p 1468.
Lamberti JJ, Mainwaring RD. Congenital anomalies of the mitral valve. In: Constantine Mavroidis (ed.). Pediatric Cardiac Surgery, 2nd edn. Mosby, St. Louis, Missouri, 1994, pp 463–464.
Alexiou J, Galogavrou M, Chen O, et al. Mitral valve replacement with mechanical prostheses in children: improved operative risk and survival. Eur J Cardiothorac Surg 2001; 20: 105–113.Google Scholar
Dunn JM. Porcine valve durability in children. Ann Thorac Surg 1981; 32: 357.Google Scholar
Ross DN. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet 1967; 2: 956–958.Google Scholar
Elkins RC, Lane MM, Mc Cue C. Ross operation in children: late results. J Heart Valve Dis 2001; 10: 736–741.Google Scholar
Kabbani SS, Jamil H, Hammoud A, et al. Use of the pulmonary autograft for mitral replacement: short- and medium-term experience. Eur J Cardiothorac Surg 2001; 20: 257–261.Google Scholar
Zweng TN, Bluett MK, Mosca R, Callow LB, Bove EL. Mitral valve replacement in the first 5 years of life. Ann Thorac Surg 1989; 47: 720–724.Google Scholar
Kadoba K, Jonas RA, Mayer JE, Castaneda AR. Mitral valve replacement in the first year of life. J Thorac Cardiocasc Surg 1990; 100: 762–768.Google Scholar
Guyton SW, Paull DL, Anderson RP. Mitral valve reconstruction. Am J Surg 1992; 163: 497–501.Google Scholar
Lamberti JJ, Jensen TS, Grehl TM, et al. Late reoperation for systemic atrioventricular valve regurgitation after repair of congenital heart defects. Ann Thorac Surg 1989; 47: 517–522.Google Scholar
Yoshimura N, Yamaguchi M, Oshima Y, et al. Surgery for mitral valve disease in the pediatric age group. J Thorac Cardiovasc Surg 1999; 118: 99–106.Google Scholar
Lorier G, Kalil RA, Barcellos C, et al. Valve repair in children with congenital mitral lesions: late clinical results. Pediatr Cardiol 2001; 22: 44–52.Google Scholar