Mitral Valvuloplasty in Pediatric Cardiac Surgery: the Range of Pathology and Results

Aleksei E. Chernogrivov, Igor E. Chernogrivov, Vladlen V. Bazylev

The FSGE Federal center of cardiovascular surgery of the Ministry of Healthcare of Russian Federation (Penza), PENZA, Russia

Date, time and location: 2018.05.25 13:30, Press Hall, 2F

Abstract

OBJECTIVE: To analyze the results of plastic surgery on the mitral valve in children, depending on the hemodynamics of the basic congenital heart disease.

MATERIALS: We reviewed clinical records of 30 children (<18 years old) who underwent mitral valverepair between November 2008 to November 2017. The range of the pathology was presented by diverse anatomical substrate but all patients were ultimately being divided into two groups: I - group 16 (53%) with a predominance of insufficiency, II - group 14 (47%) with a predominance of mitral stenosis. Associated intracardiac defects were present in 9 (56%) patients in group I and 10 (71%) in group II. Characteristics of patients in groups: Group I age ranged from 1.5 months to 14 years, Me = 517 days; body weight varies 4-50 kg, Me = 8.5 kg (3.7-50); Group II patients aged 3.5 months to 5 years, Me = 358 days; body weight was 3.4-13 kg, Me=8.15 (4.7-10.1).

RESULT: Overall hospital mortality was 6% (2/30), one patient per each group. In the long term, the median time of observation was 5.5 years. The long-term mortality was 3.5% (1/28), the patient was from group II. In the long term, three patients (10%) required re-operations: in 2 cases repeated valve reconstructions and in 1 case the replacement of the valve with mechanical prostheses. Freedom from repeated interventions, up to 9 years in groups, was 82.5 ± 11.5% and 75.7 ± 21.7%, respectively. The long-term actuarial survival in groups was 100% and 92%, respectively.

CONCLUSIONS: Reconstructive procedures of the mitral valve, regardless of the initial anatomo-hemodynamic characteristics of the defect, can be relatively safe. In the mid- and long-term period, an acceptable and satisfactory function of the reconstructed valve has been defined, although in both groups is noted some risk of repeated interventions.