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Erschienen in: Pediatric Cardiology 8/2017

31.07.2017 | Original Article

The Mid-term Results of Mitral Valve Repair for Isolated Mitral Regurgitation in Infancy and Childhood

verfasst von: Yi Shi, Haitao Xu, Jun Yan, Qiang Wang, Shoujun Li, Tong Yi, Yajuan Zhang, Wenchao Liu

Erschienen in: Pediatric Cardiology | Ausgabe 8/2017

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Abstract

The objective of this study was to assess the mid-term results of mitral valve (MV) repair in infancy and childhood with isolated mitral regurgitation (MR). From January 2005 to January 2016, 40 consecutive patients with isolated MR underwent MV repair in Fuwai Hospital, Beijing, China. Patients’ clinical data were analyzed retrospectively. Mean age at operation was 13 ± 5 (6–24) months and 22 patients (55%) were younger than 1 year. Mean weight at operation was 8.5 ± 1.9 (4.2–13) kg and 34 patients (85%) were lighter than 10 kg. All patients presented moderate or greater MR. After MV repair, all patients had mild MR or none, while two patients underwent re-repair immediately when TEE showed moderate MR. Mean left atrial diameter decreased from 28.0 ± 6.5 to 20.7 ± 4.8 mm and mean left ventricular end-diastolic diameter decreased from 38.6 ± 7.0 to 30.2 ± 4.9 mm (p < 0.001 for both). There was no early death. Clinical follow-up was conducted in 37 patients over an average period of 49 ± 31 (20–134) months. Follow-up echocardiography showed that one patient had severe MR who underwent redo repair 14 months after operation, one patient had moderate to severe MR, and three patients had moderate MR. Overall freedom from moderate or greater MR was 96.3 ± 3.6%, 91.9 ± 5.5%, and 83.6 ± 9.4% at 2, 5, and 10 years, respectively. The early and mid-term results of MV repair in pediatric patients with isolated MR were satisfactory. In majority of patients, less complex surgical repair techniques were utilized, namely annuloplasty or commissuroplasty. The combination of various repair methods in complex patients could achieve excellent outcome.
Literatur
1.
Zurück zum Zitat Kouchoukos NT, Blackstone EH (2013) Kirklin/Barratt-Boyes Cardiac Surgery. Congenital mitral valve disease, 4th edn. Churchill Livingstone, England, pp 1814–1817 Kouchoukos NT, Blackstone EH (2013) Kirklin/Barratt-Boyes Cardiac Surgery. Congenital mitral valve disease, 4th edn. Churchill Livingstone, England, pp 1814–1817
2.
Zurück zum Zitat Jiang Z, Mei J, Ding F et al (2014) The early and mid-term results of mitral valve repair for mitral regurgitation in children. Surg Today 44:2086–2091CrossRefPubMed Jiang Z, Mei J, Ding F et al (2014) The early and mid-term results of mitral valve repair for mitral regurgitation in children. Surg Today 44:2086–2091CrossRefPubMed
3.
Zurück zum Zitat Lee C, Lee CH, Kwak JG et al (2010) Long-term results after mitral valve repair in children. Eur J Cardiothorac Surg 37:267–272PubMed Lee C, Lee CH, Kwak JG et al (2010) Long-term results after mitral valve repair in children. Eur J Cardiothorac Surg 37:267–272PubMed
4.
Zurück zum Zitat Wood AE, Healy DG, Nolke L et al (2005) Mitral valve reconstruction in a pediatric population: late clinical results and predictors of long-term outcome. J Thorac Cardiovasc Surg 130:66–73CrossRefPubMed Wood AE, Healy DG, Nolke L et al (2005) Mitral valve reconstruction in a pediatric population: late clinical results and predictors of long-term outcome. J Thorac Cardiovasc Surg 130:66–73CrossRefPubMed
5.
Zurück zum Zitat Hetzer R, Delmo Walter EM, Hübler M et al (2008) Modified surgical techniques and long-term outcome of mitral valve reconstruction in 111 children. Ann Thorac Surg 86:604–613CrossRefPubMed Hetzer R, Delmo Walter EM, Hübler M et al (2008) Modified surgical techniques and long-term outcome of mitral valve reconstruction in 111 children. Ann Thorac Surg 86:604–613CrossRefPubMed
6.
Zurück zum Zitat Ando M, Takahashi Y (2016) Durability of mitral valve repair performed before the age of 5 years. Circ J 80:124–129CrossRefPubMed Ando M, Takahashi Y (2016) Durability of mitral valve repair performed before the age of 5 years. Circ J 80:124–129CrossRefPubMed
7.
Zurück zum Zitat Kalfa D, Vergnat M, Ly M et al (2014) A standardized repair-oriented strategy for mitral insufficiency in infants and children: midterm functional outcomes and predictors of adverse events. J Thorac Cardiovasc Surg 148:1459–1466CrossRefPubMed Kalfa D, Vergnat M, Ly M et al (2014) A standardized repair-oriented strategy for mitral insufficiency in infants and children: midterm functional outcomes and predictors of adverse events. J Thorac Cardiovasc Surg 148:1459–1466CrossRefPubMed
8.
Zurück zum Zitat Aubert S, Barreda T, Acar C et al (2005) Mitral valve repair for commissural prolapse: surgical techniques and long term results. Eur J Cardiothorac Surg 28:443–447CrossRefPubMed Aubert S, Barreda T, Acar C et al (2005) Mitral valve repair for commissural prolapse: surgical techniques and long term results. Eur J Cardiothorac Surg 28:443–447CrossRefPubMed
9.
Zurück zum Zitat Delmo Walter EM, Siniawski H, Ovroutski S et al (2010) Mitral valve growth after posterior annular stabilization with untreated autologous pericardial strip in children with mitral valve insufficiency. Ann Thorac Surg 90:1577–1585CrossRefPubMed Delmo Walter EM, Siniawski H, Ovroutski S et al (2010) Mitral valve growth after posterior annular stabilization with untreated autologous pericardial strip in children with mitral valve insufficiency. Ann Thorac Surg 90:1577–1585CrossRefPubMed
10.
Zurück zum Zitat Chang BC, Youn YN, Ha JW et al (2007) Long-term clinical results of mitral valvuloplasty using flexible and rigid rings: a prospective and randomized study. J Thorac Cardiovasc Surg 133:995–1003CrossRefPubMed Chang BC, Youn YN, Ha JW et al (2007) Long-term clinical results of mitral valvuloplasty using flexible and rigid rings: a prospective and randomized study. J Thorac Cardiovasc Surg 133:995–1003CrossRefPubMed
11.
Zurück zum Zitat Chauvaud S, Fuzellier JF, Houel R et al (1998) Reconstructive surgery in congenital mitral valve insufficiency (Carpentier’s techniques): long-term results. J Thorac Cardiovasc Surg 115:84–93CrossRefPubMed Chauvaud S, Fuzellier JF, Houel R et al (1998) Reconstructive surgery in congenital mitral valve insufficiency (Carpentier’s techniques): long-term results. J Thorac Cardiovasc Surg 115:84–93CrossRefPubMed
12.
Zurück zum Zitat Stellin G, Padalino M, Milanesi O et al (2000) Repair of congenital mitral valve dysplasia in infants and children: is it always possible? Eur J Cardiothorac Surg 18:74–82CrossRefPubMed Stellin G, Padalino M, Milanesi O et al (2000) Repair of congenital mitral valve dysplasia in infants and children: is it always possible? Eur J Cardiothorac Surg 18:74–82CrossRefPubMed
13.
Zurück zum Zitat Hetzer R, Delmo Walter EM (2014) No ring at all in mitral valve repair: indications, techniques and longterm outcome. Eur J Cardiothorac Surg 45:341–351CrossRefPubMed Hetzer R, Delmo Walter EM (2014) No ring at all in mitral valve repair: indications, techniques and longterm outcome. Eur J Cardiothorac Surg 45:341–351CrossRefPubMed
14.
Zurück zum Zitat Hisatomi K, Isomura T, Sate T et al (1996) Mitral valve repair for mitral regurgitation with ventricular septal defect in children. Ann Thorac Surg 62:1773–1777CrossRefPubMed Hisatomi K, Isomura T, Sate T et al (1996) Mitral valve repair for mitral regurgitation with ventricular septal defect in children. Ann Thorac Surg 62:1773–1777CrossRefPubMed
15.
Zurück zum Zitat Yoshimura N, Yamaguchi M, Oshima Y et al (1999) Surgery for mitral valve disease in the pediatric age group. J Thorac Cardiovasc Surg 118:99–106CrossRefPubMed Yoshimura N, Yamaguchi M, Oshima Y et al (1999) Surgery for mitral valve disease in the pediatric age group. J Thorac Cardiovasc Surg 118:99–106CrossRefPubMed
Metadaten
Titel
The Mid-term Results of Mitral Valve Repair for Isolated Mitral Regurgitation in Infancy and Childhood
verfasst von
Yi Shi
Haitao Xu
Jun Yan
Qiang Wang
Shoujun Li
Tong Yi
Yajuan Zhang
Wenchao Liu
Publikationsdatum
31.07.2017
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 8/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-017-1701-y

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