Mitral valve replacement in the pediatric age group- a single institution experience

Department of CVTS, G.B. Pant Hospital, New Delhi, India
Indian Journal of Thoracic and Cardiovascular Surgery 25(1):7-11. DOI: 10.1007/s12055-009-0002-3

ABSTRACT BackgroundMitral valve replacement in pediatric patient is a difficult surgical task, with many intraoperative and post-operative considerations.
We conducted this study to evaluate the indications and early results of mitral valve replacement in children.

MethodsFrom January 2003 to July 2008, fifty-four children under the age of fifteen years underwent mitral valve replacement at our
institution. All children received a mechanical bi-leaflet or tilting disc prosthetic valve. All of them underwent valve replacement
on the basis of preoperative echocardiography and intraoperative assessment of valve pathology.

ResultsPreoperatively 65% of the children were in New York Heart Association (NYHA) class III and 35% of them were in NYHA class
IV. The cause of mitral valve disease was chronic rheumatic valve disease in 97% of cases and congenital in 3% of the cases.
In the rheumatic group 66% of them had severe mitral regurgitation as predominant lesion. The mean diameter of the implanted
valve was 27.17mm. There was no hospital or 30 day mortality. The mean follow-up period was 3.6 years. One patient died after
2 years from a stuck valve. Two other patients required thrombolysis for stuck valves. 53 patients are doing well at last
follow up.

ConclusionsMitral valve replacement in children is a safe alternative to valve repair when the morphology is not suitable for repair,
with acceptable immediate and early outcomes.

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