Skip to main content
Erschienen in: Surgery Today 11/2014

01.11.2014 | Original Article

The early and mid-term results of mitral valve repair for mitral regurgitation in children

verfasst von: Zhaolei Jiang, Ju Mei, Fangbao Ding, Chunrong Bao, Jiaquan Zhu, Min Tang, Nan Ma, Jianbing Huang, Saie Shen

Erschienen in: Surgery Today | Ausgabe 11/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To review the surgical techniques and mid-term results of mitral valve repair in children with moderate or severe mitral regurgitation (MR).

Methods

One hundred and seven children with moderate or severe MR, aged 19.6 ± 8.5 months, were enrolled in this study. The surgical techniques used for mitral valve repair varied according to the mitral valve morphology, and included annuloplasty, annuloplasty ring, cleft closure, reconstruction of the posterior leaflet, etc. The concomitant cardiac anomalies were treated simultaneously. The results of repair were evaluated by transesophageal echocardiography performed during the operation and by serial transthoracic echocardiography performed during the follow-up.

Results

One hundred and six cases had no more than mild regurgitation intraoperatively, whereas only one case had moderate regurgitation. This patient underwent redo repair immediately, and the subsequent regurgitation was trivial. The in-hospital mortality rate was 0.9 % (1/107). The average follow-up was 46.5 ± 8.2 months. One patient died of heart failure 10 months postoperatively. The freedom from moderate or severe regurgitation after mitral valve repair was 92.3 ± 3.3 %.

Conclusion

Pediatric patients with moderate or severe MR require early surgical treatment. The early and mid-term results of mitral valve repair in pediatric patients were satisfactory.
Literatur
1.
Zurück zum Zitat Cohn LH. Mitral valve repair. Mastery of cardiothoracic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins Inc; 2007. p. 341–52. Cohn LH. Mitral valve repair. Mastery of cardiothoracic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins Inc; 2007. p. 341–52.
2.
Zurück zum Zitat Rochae Silva A, Herdy GV, Vieira AA, Simões LC. Surgical mitral valve repair in children with rheumatic fever. Arq Bras Cardiol. 2009;92(6):400–4 (417–21, 433–8). Rochae Silva A, Herdy GV, Vieira AA, Simões LC. Surgical mitral valve repair in children with rheumatic fever. Arq Bras Cardiol. 2009;92(6):400–4 (417–21, 433–8).
3.
Zurück zum Zitat Pedrazzini GB, Faletra F, Vassalli G, Demertzis S, Moccetti T. Mitral regurgitation. Swiss Med Wkly. 2010;140(3–4):36–43.PubMed Pedrazzini GB, Faletra F, Vassalli G, Demertzis S, Moccetti T. Mitral regurgitation. Swiss Med Wkly. 2010;140(3–4):36–43.PubMed
4.
Zurück zum Zitat Brizard C. Mitral valve repair in children. Mastery of cardiothoracic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins Inc; 2007. p. 1008–16. Brizard C. Mitral valve repair in children. Mastery of cardiothoracic surgery. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins Inc; 2007. p. 1008–16.
5.
Zurück zum Zitat 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.PubMed 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.PubMed
6.
Zurück zum Zitat 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;115:84–92 (discussion 92–93).PubMedCrossRef 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;115:84–92 (discussion 92–93).PubMedCrossRef
7.
Zurück zum Zitat Minich LL, Atz AM, Colan SD, Sleeper LA, Mital S, Jaggers J, et al. Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg. 2010;89(2):530–6.PubMedCrossRefPubMedCentral Minich LL, Atz AM, Colan SD, Sleeper LA, Mital S, Jaggers J, et al. Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg. 2010;89(2):530–6.PubMedCrossRefPubMedCentral
8.
Zurück zum Zitat Wood AE, Healy DG, Nolke L, Duff D, Oslizlok P, Walsh K. Mitral valve reconstruction in a pediatric population: late clinical results and predictors of long-term outcome. J Thorac Cardiovasc Surg. 2005;130(1):66–73.PubMedCrossRef Wood AE, Healy DG, Nolke L, Duff D, Oslizlok P, Walsh K. Mitral valve reconstruction in a pediatric population: late clinical results and predictors of long-term outcome. J Thorac Cardiovasc Surg. 2005;130(1):66–73.PubMedCrossRef
9.
Zurück zum Zitat Shuhaiber J, Anderson RJ. Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement. Eur J Cardiothorac Surg. 2007;31:267–75.PubMedCrossRef Shuhaiber J, Anderson RJ. Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement. Eur J Cardiothorac Surg. 2007;31:267–75.PubMedCrossRef
10.
Zurück zum Zitat Beierlein W, Becker V, Yates R, Tsang V, Elliott M, de Leval M, et al. Long-term follow-up after mitral valve replacement in childhood: poor event-free survival in the young child. Eur J Cardiothorac Surg. 2007;31(5):860–5.PubMedCrossRef Beierlein W, Becker V, Yates R, Tsang V, Elliott M, de Leval M, et al. Long-term follow-up after mitral valve replacement in childhood: poor event-free survival in the young child. Eur J Cardiothorac Surg. 2007;31(5):860–5.PubMedCrossRef
11.
Zurück zum Zitat Tesler UF, Cerin G, Novelli E, Popa A, Diena M. Evolution of surgical techniques for mitral valve repair. Tex Heart Inst J. 2009;36(5):438–40.PubMedPubMedCentral Tesler UF, Cerin G, Novelli E, Popa A, Diena M. Evolution of surgical techniques for mitral valve repair. Tex Heart Inst J. 2009;36(5):438–40.PubMedPubMedCentral
12.
Zurück zum Zitat Curi–Curi P, Ramírez-Marroquín S, Cervantes-Salazar J, Soulé M, Erdmenger J, Calderón-Colmenero J. Surgical repair of congenital mitral valve malformations. Arch Cardiol Mex. 2010;80(2):87–94.PubMed Curi–Curi P, Ramírez-Marroquín S, Cervantes-Salazar J, Soulé M, Erdmenger J, Calderón-Colmenero J. Surgical repair of congenital mitral valve malformations. Arch Cardiol Mex. 2010;80(2):87–94.PubMed
13.
Zurück zum Zitat Zias EA, Mavroudis C, Backer CL, Kohr LM, Gotteiner NL, Rocchini AP. Surgical repair of the congenitally malformed mitral valve in infants and children. Ann Thorac Surg. 1998;66(5):1551–9.PubMedCrossRef Zias EA, Mavroudis C, Backer CL, Kohr LM, Gotteiner NL, Rocchini AP. Surgical repair of the congenitally malformed mitral valve in infants and children. Ann Thorac Surg. 1998;66(5):1551–9.PubMedCrossRef
14.
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
15.
Zurück zum Zitat Stellin G, Padalino MA, 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(6):1238–44.PubMedCrossRef Stellin G, Padalino MA, 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(6):1238–44.PubMedCrossRef
16.
Zurück zum Zitat Hetzer R, Delmo Walter EB, Hübler M, Alexi-Meskishvili V, Weng Y, Nagdyman N, et al. Modified surgical techniques and long-term outcome of mitral valve reconstruction in 111 children. Ann Thorac Surg. 2008;86(2):604–13.PubMedCrossRef Hetzer R, Delmo Walter EB, Hübler M, Alexi-Meskishvili V, Weng Y, Nagdyman N, et al. Modified surgical techniques and long-term outcome of mitral valve reconstruction in 111 children. Ann Thorac Surg. 2008;86(2):604–13.PubMedCrossRef
17.
Zurück zum Zitat Sheikh KH, Bengtson JR, Rankin JS, de Bruijn NP, Kisslo J. Intraoperative transesophageal Doppler color flow imaging used to guide patient selection and operative treatment of ischemic mitral regurgitation. Circulation. 1991;84:594–604.PubMedCrossRef Sheikh KH, Bengtson JR, Rankin JS, de Bruijn NP, Kisslo J. Intraoperative transesophageal Doppler color flow imaging used to guide patient selection and operative treatment of ischemic mitral regurgitation. Circulation. 1991;84:594–604.PubMedCrossRef
18.
Zurück zum Zitat Mahadin DR, Srivastava S, Parness IA, Nguyen K, Love BA, Walsh R, et al. Outcomes of mitral regurgitation associated with large ventricular septal defect and a normal mitral valve apparatus: does intact atrial septum have an impact? Pediatr Cardiol. 2011;32(8):1128–31.PubMedCrossRef Mahadin DR, Srivastava S, Parness IA, Nguyen K, Love BA, Walsh R, et al. Outcomes of mitral regurgitation associated with large ventricular septal defect and a normal mitral valve apparatus: does intact atrial septum have an impact? Pediatr Cardiol. 2011;32(8):1128–31.PubMedCrossRef
19.
Zurück zum Zitat Gunther T, Mazzitelli D, Schreiber C. Mitral valve replacement in children under 6 years of age. Eur J Cardio Thorac Surg. 2000;17(4):426–30.CrossRef Gunther T, Mazzitelli D, Schreiber C. Mitral valve replacement in children under 6 years of age. Eur J Cardio Thorac Surg. 2000;17(4):426–30.CrossRef
20.
Zurück zum Zitat Hisatomi K, Isomura T, Sato T, Kosuga K, Ohishi K, Katoh H. Mitral valve repair for mitral regurgitation with ventricular septal defect in children. Ann Thorac Surg. 1996;62(6):1773–7.PubMedCrossRef Hisatomi K, Isomura T, Sato T, Kosuga K, Ohishi K, Katoh H. Mitral valve repair for mitral regurgitation with ventricular septal defect in children. Ann Thorac Surg. 1996;62(6):1773–7.PubMedCrossRef
21.
Zurück zum Zitat Berrebi A. Mitral valve repair: echocardiography is its best friend. Rev Esp Cardiol. 2011;64(7):554–6.CrossRef Berrebi A. Mitral valve repair: echocardiography is its best friend. Rev Esp Cardiol. 2011;64(7):554–6.CrossRef
22.
Zurück zum Zitat Sakaguchi T, Nishi H, Miyagawa S, Yoshikawa Y, Fukushima S, Yoshioka D, et al. One-knot technique: a simple modification of the loop technique for mitral valve repair. Surg Today. 2013;43(6):705–7.PubMedCrossRef Sakaguchi T, Nishi H, Miyagawa S, Yoshikawa Y, Fukushima S, Yoshioka D, et al. One-knot technique: a simple modification of the loop technique for mitral valve repair. Surg Today. 2013;43(6):705–7.PubMedCrossRef
23.
Zurück zum Zitat Aharon AS, Laks H, Drinkwater DC, Chugh R, Gates RN, Grant PW, et al. Early and late results of mitral valve repair in children. J Thorac Cardiovasc Surg. 1994;107:1262–71.PubMed Aharon AS, Laks H, Drinkwater DC, Chugh R, Gates RN, Grant PW, et al. Early and late results of mitral valve repair in children. J Thorac Cardiovasc Surg. 1994;107:1262–71.PubMed
24.
Zurück zum Zitat Delmo Walter EM, Hetzer R. Mitral valve repair in children. Mitral Valve Repair, II. Darmstadt, Germany: Steinkopff; 2011. p. 41–56. Delmo Walter EM, Hetzer R. Mitral valve repair in children. Mitral Valve Repair, II. Darmstadt, Germany: Steinkopff; 2011. p. 41–56.
Metadaten
Titel
The early and mid-term results of mitral valve repair for mitral regurgitation in children
verfasst von
Zhaolei Jiang
Ju Mei
Fangbao Ding
Chunrong Bao
Jiaquan Zhu
Min Tang
Nan Ma
Jianbing Huang
Saie Shen
Publikationsdatum
01.11.2014
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 11/2014
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0816-x

Weitere Artikel der Ausgabe 11/2014

Surgery Today 11/2014 Zur Ausgabe

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Metformin rückt in den Hintergrund

24.04.2024 DGIM 2024 Kongressbericht

Es hat sich über Jahrzehnte klinisch bewährt. Doch wo harte Endpunkte zählen, ist Metformin als alleinige Erstlinientherapie nicht mehr zeitgemäß.

Myokarditis nach Infekt – Richtig schwierig wird es bei Profisportlern

24.04.2024 DGIM 2024 Kongressbericht

Unerkannte Herzmuskelentzündungen infolge einer Virusinfektion führen immer wieder dazu, dass junge, gesunde Menschen plötzlich beim Sport einen Herzstillstand bekommen. Gerade milde Herzbeteiligungen sind oft schwer zu diagnostizieren – speziell bei Leistungssportlern. 

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.