Mitral valve reconstruction in a pediatric population: Late clinical results and predictors of long-term outcome

Abstract

This series compares favorably with others, with 74% to 85% survival and 66% to 85.7% freedom from reoperation reported with valve replacement. Patients with significant associated congenital cardiac abnormalities are at a higher risk of early death after mitral reconstructive surgery.

Plastia mitral cirúrgica em crianças com febre reumática

“…Annuloplasty was the single procedure used in only eight of the patients studied (20%), thus demonstrating that in most of the cases (80%) the association with more than one technique was necessary, and in many occasions with modifications of the initial planning, a situation that has also been described by other authors 6,10,16 . Mitral annulus dilatation is present in almost all patients with mitral regurgitation.…”

“…Absence of thromboembolism after mitral repair is reported in 87% to 99% of the cases after five years. Most of the embolic manifestations are cerebrovascular events [10][11][12] .…”

“…This is due to the displacement of its posterior portion, since the anterior portion is limited by the right and left fibrous trigones of heart. According to the literature, repair is considered a good option, because it permits the conservation of the native valve cusps and of the subvalvular apparatus, thus preserving the left ventricular geometry and ventricular function 10 .…”

“…Transesophageal echocardiography has been established as the most adequate method for the assessment of immediate outcomes, guiding the need for valve replacement in the cases of failure in mitral repair or significant residual regurgitation 10 . Murad et al 6 reported the use of transesophageal echocardiography in only 4% of their surgeries.…”

“…In lower age ranges, prosthesis replacement is necessary because of height and weight growth. Based on these facts, surgeons have used reconstructive techniques in the treatment of mitral valve regurgitation with increasing frequency 9,10 . The objectives of the present study were to analyze the results of mitral valve repair in patients with rheumatic fever, to evaluate the patients' outcome, and to determine the factors that could influence the need for valve replacement before four years of follow-up.…”