Midterm surgical outcomes for mitral valve regurgitation in children

Objective To evaluated the midterm outcomes of mitral valvuloplasty in children. Methods The clinical data were retrospectively analyzed for 40 infants and young children of mitral insufficiency undergoing primary mitral valvuloplasty from January 2005 to January 2015.During this period, 40 children with moderate-severe mitral regurgitation (MR) aged (13±5) months and weighted (8.5±1.9) kilograms were operated.Twenty-two (55%) were aged under 12 months.MR was severe (n=27), midterm-severe (n=10) and midterm (n=3). The preoperative mean left ventricular ejection fraction was (65.3%±10.1%), the mean preoperative left atrial diameter (28±8.2) mm and the mean left ventricle diameter (37.9±7.5) mm. Results All of them underwent mitral valvuloplasty under general anesthesia and hypothermic cardiopulmonary bypass (CPB). Mean CPB time was (78.2±34.3) min and mean aortic clump time (57.2±23.5) min.There was no in-hospital mortality.Mean length of stay was (17.8±7.9) days.The mean left atrial diameter was (21.0±4.7) mm and the left ventricular diameter (30.3±4.9) mm at 1 month postoperatively.And the difference was statistically significant as compared with that preoperatively (P<0.05). For 37 cases (92.5%), the average follow-up period was (37±31) months.Echocardiography showed that MR was mild (n=7), mild-moderate (n=4), moderate (n=3) and severe (n=1). One patient underwent re-do mitral valve repair.There was no late mortality.The follow-up results showed that mean left atrial diameter was (23.5±6.9) mm and left ventricular diameter (33.0±5.7) mm.Both were significantly different from those preoperatively (P<0.05). The difference was statistically significant before and after follow-ups (P<0.01). Conclusions Surgical repair of congenital mitral valve may be successfully performed with low mortality, satisfactory valvular function at midterm follow-up and acceptable reoperative rate.Patients with moderate-severe MR need early surgery and individualized treatment based on specific pathology is essential for surgery.