The outcomes of reoperation for congenital mitral valve diseases in children

BACKGROUNDS: We aimed to study the outcomes of mitral valve (MV) reoperations in children with congenital MV diseases and to summarize our treatment experience. METHODS: In this single-center retrospective study, we enrolled 24 patients aged < 18 years who underwent MV reoperation from among 265 patients who underwent MV repair between January 2013 and July 2023. MV reoperations were based on the types of MV disease. Cox regressions were used to analyze the risk factors for death and second MV reoperation. RESULTS: A total of 5 patients underwent second MV reoperations. 3 patients experienced early death, and 1 experienced late death. The 3- and 5-year survival rates of the entire cohort were 86.6% ± 7.3% and 72.1% ± 14.5%, respectively. Patients who had the double-orifice MV technique applied during MV reoperation were significantly more prone to receive mechanical MV replacement (P < 0.0001). The use of double-orifice MV technique during MV reoperation was identified as an independent risk factor for second MV reoperation (HR = 8.136, 95%CI = 1.099-60.240; P = 0.040). CONCLUSIONS: The reoperation of the MV in children with congenital MV diseases poses a formidable challenge, manifested by a high postoperative mortality rate and re-intervention rate. Patiently and meticulously repair based on the types of MV disease has demonstrated the capacity to enhance and sustain stable valve function and cardiac function in the vast majority of children. The use of the double-orifice MV technique did not achieve ideal therapeutic results in children with complex valve lesions.