Results of Mitral Valve Repair in Patients with Congenital Mitral Disease / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Mitral valve abnormalities in the pediatric population are rare. Mitral valve replacement for pediatric mitral lesions can cause problems such as a lack of growth potential. There are only limited experiences with mitral valve repair at any institution, so the purpose of this study is to evaluate the outcomes of mitral valve repair in pediatric patients. MATERIAL AND METHOD: Sixty-four consecutive children (28 males and 36 females) with a mean age of 5.5+/-4.7 years underwent mitral valve repair for treating their congenital mitral valve disease between January 1996 and December 2005. The patients were divided into two groups group 1 (34 patients (53.1%)) had isolated disease (mitral anomaly with or without atrial septal defect or patent ductus arteriosus) and group 2 (30 patients (46.9%)) had complex disease (mitral anomaly with concurrent intracardiac disease, except atrioventricular septal defect). RESULT: The overall in-hospital mortality was 6.3%; group 1 had 5.9% mortality and group 2 had 10.0% mortality. The postoperative morbidity was 18.8%; group 1 and 2 had 14.7% and 23.3% postoperative morbidity, respectively, and there was no significant difference among the groups. The median follow-up was 4.6 years (range 0.5~12.2 years). The 10-year survival rate was 95.3%. The 10-year freedom from re-operation rate was 76.1% with 10 re-operations. The majority of the functional classifications were annular dilatation and leaflet prolapse. A mean of 2.1+/-1.1 procedures per patient were performed. The echocardiography that was done at the immediate postoperative period showed a significant improvement in the mitral valve function. The follow-up echocardiographic results were significantly improved. However, mitral stenosis newly developed over time, and there were significant differences according to the repair strategies. CONCLUSION: The patients who underwent mitral valve repair for congenital mitral anomalies showed good results. The follow-up echocardiography revealed satisfactory short-term and long-term results. Close follow-up is necessary to detect the development of postoperative mitral stenosis or regurgitation.