Key result
In infants weighing less than 10 kg undergoing mechanical mitral valve replacement, a prosthetic valve size to body weight ratio of 3 or greater was significantly associated with increased mortality compared to a ratio below 3 (60% vs 0%, p=0.03).
Why the study?
Outcomes of mitral valve replacement in pediatrics, especially in patients weighing less than 10 kg, are not always favorable.
Does mitral valve replacement with mechanical prostheses provide favorable long-term outcomes in pediatric patients weighing less than 10 kg?
Observational (n=9)
No
Does mitral valve replacement with mechanical prostheses provide favorable long-term outcomes in pediatric patients weighing less than 10 kg?
Answers are grounded in this paper and cite their sources.
Mitral valve replacement with bileaflet mechanical prostheses in infants weighing less than 10 kg demonstrates reliable valve function and acceptable long-term durability without the need for reintervention.
BACKGROUND: The outcomes of mitral valve replacement (MVR) in pediatrics especially in the patients weighing less than 10 kg are not always favorable. This study aimed to measure long-term outcomes of MVR in our institution. METHODS: Nine young children weighing less than 10 kg underwent MVR with mechanical prostheses were enrolled in this retrospectively study. Kaplan-Meier survival analysis was used for the prediction of freedom from death and adverse events. Chi-square test was performed to compare outcomes for patients with different ratios of mechanical prosthesis size and body weight. Fourteen related literatures were also reviewed to support our study. RESULTS: All patients received bileaflet mechanical prostheses replacement. The surgical technique varied among the patients with prostheses implanted in the intra-annular (n = 5), supra-annular (n = 1), or with a Dacron conduit segment in the supra-annular position (n = 3). The valve size/weight ratio ranged from 2.11 to 5.00. There were two early death and one late death post-operation. The mean follow-up period was 80.67 ± 63.37 months, the transvalvular gradient was 10.5 ± 1.76 mmHg (range 8 to 12) and the peak gradient of LVOT was 5.00 ± 0.64 mmHg. One (11.1%) patient underwent an immediate revision MVR after initial MVR due to the periprosthetic leak. No patients required surgical reintervention or permanent pacemaker placement during long-term follow-up. CONCLUSIONS: The tailored surgical strategy utilized for MVR in infants resulted in reliable valve function and excellent survival. Although revision is inevitable due to somatic growth, the bileaflet mechanical prostheses displayed appropriate durability.
No takes yet. Share an insight, caveat, or question.
Yuan et al. (2021) conducted an observational in Mitral valve diseases (n=9). Mechanical mitral valve replacement (valve size to body weight ratio ≥3) vs. Valve size to body weight ratio <3 was evaluated on Mortality (p=0.03). In infants weighing less than 10 kg undergoing mechanical mitral valve replacement, a prosthetic valve size to body weight ratio of 3 or greater was significantly associated with increased mortality compared to a ratio below 3 (60% vs 0%, p=0.03).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: