Analysis of the mid and long term results of mitral valve replacement in 48 cases / 中华胸心血管外科杂志

ABSTRACT

Objective To study the mid-and long-term outcomes and prognostic risk factors of mitral valve replacement (MVR) in children.Methods Retrospectively studied the cases(＜ 14 years) receiving MVR between July 2003 and March 2014 in our hospital,and recorded the gender,age,operation related data and the results of echocardiography,electrocardiogram and chest X-ray in the out-patient department.Results A total of 48 patients were followed up.Age was 8 months 15 days-13 years 9 months and 22 days,the average was (9.5 ± 3.9) years.24 cases were original operations,others were second operations.43 mechanical valves were used,as well as 5 tissue valves.The mortality was 8.3 ％ and the incidence of complications was 25.0％ during the hospitalization or within 30 days after the operations.Follow-up time was 4.7-150.7 months,the average was(62.0 ± 42.3) months.The long-term mortality was 9.1％,and the incidence of complications was 9.4％.Follow-up of left ventricular ejection fraction was 0.30-0.77,the average was 0.61 ±0.08.There was no redo-MVR or implantation of pace maker.The survival rates of 1 year,5 years and 10 years were (89.5 ± 4.5) ％、(83.0 ± 6.1) ％、(77.8 ±7.6)％,respectively.Children younger than 5 years was the risk factor for perioperative mortality or complications (OR =8.47,95％ CI1.36-52.61).Children with perioperative complications was the risk factor for long-term mortality or complications(OR =9.97,95％ CI1.39-71.76).Conclusion The results of children with MVR were satisfactory.To perform MVR in children older than 5 years if possible and to reduce the incidence of perioperative complications could improve the prognosis.