Mitral valve replacement in the first 5 years of life

Zweng, Thomas N.; Bluett, Michael K.; Mosca, Ralph S.; Callow, Louise; Bove, Edward L.

doi:10.1016/0003-4975(89)90126-4

Cited by 63 publications

(44 citation statements)

References 26 publications

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“…Other investigators have also reported a high operative mortality 7-10. Mitral stenosis has previously been identified as a risk factor,9 10 but this was not confirmed in our series. Placement of the valve in the supra-annular position was related to poor outcome in some studies,15 16 but not in others 11.…”

Section: Discussioncontrasting

confidence: 81%

Mitral valve replacement in children: mortality, morbidity, and haemodynamic status up to medium term follow up

Doorn

Yates

Tsang

et al. 2000

Heart

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Objective-To investigate the outcome of mechanical mitral valve replacement in children after up to 11 years of follow up. Design-Retrospective analysis of case records. Operative survivors underwent echocardiographic studies to define current haemodynamic status and prosthetic valve function. Setting-Tertiary referral centre. Patients-All 54 children who underwent mitral valve replacement between January 1987 and December 1997. Results-30 day mortality was 20.3% and was associated with small valve size and supra-annular position. The actuarial freedom from the following events at five years (70% confidence interval (CI)) was: death, including 30 day mortality and transplantation, 68% (70% CI 62% to 75%); bleeding, 89% (70% CI 84% to 94%); non-structural valve dysfunction and reoperation, 92% (70% CI 87% to 97%). The incidence of endocarditis and thromboembolism was low and there was no structural valve failure. Event-free survival was 52% (70% CI 45% to 60%). Low weight, young age, and small valve size increased the chance of death or reoperation. On echocardiography, left ventricular dilatation and wall motion abnormalities were often observed. A high mean gradient over the prosthesis was associated with small valve size but not with length of follow up. Conclusions-With the use of mechanical prostheses for mitral valve replacement in children, the problem of structural valve failure is no longer an issue. However, the procedure is still associated with a high complication rate, both at surgery and during follow up, and should therefore be reserved for patients in whom valve repair is not technically feasible. (Heart 2000;84:636-642)

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Section: Discussioncontrasting

confidence: 81%

Mitral valve replacement in children: mortality, morbidity, and haemodynamic status up to medium term follow up

Doorn

Yates

Tsang

et al. 2000

Heart

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“…MVR is especially challenging in younger children with congenital mitral disease due to the small size of native valve annulus, atrium and ventricle that predisposes them to complications related to leaflet entrapment, development of left ventricular outflow tract (LVOT), pulmonary veins or tricuspid valve obstruction and conduction block [9,12,[15][16][17][18][19][20]. The inferior outcomes for MVR in smaller children are well-documented in the literature [9,12,19,20].…”

Section: Introductionmentioning

confidence: 99%

Outcomes and associated risk factors for mitral valve replacement in children☆

Alsoufi

Manlhiot

Al-Ahmadi

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…Abbreviations as in Table 1. (28,29). Surgeons have oversized these valves in an attempt to accommodate for this problem; however, patient-to-valve size mismatch has been shown repeatedly to have worse outcomes (30,31).…”

Section: An Extended Methods Section Is Available In Thementioning

confidence: 97%