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Korean J Thorac Cardiovasc Surg 2007; 40(8): 536-545

Published online August 5, 2007

Copyright © Journal of Chest Surgery.

Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients

Hyung Tae Sim*, Dong Man Seo*, Tae Jin Yun*, Jeong-Jun Park*, Sung-Ho Jung*, Ju Yeon Uhm*, Won Kyoung Jhang*, Young Hwue Kim**, Jae Kon Ko**, In Sook Park**

Division of Pediatric Cardiac Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Division of Pediatric Cardiology, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years. The mean age was 5.3±5.3 years and the mean body weight was 20.0±16.3 kg. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were 93.3±4.6% and 76.1±8.2%, respectively. The 5-year freedom from mitral valve replacement rate was 83.6±6.7%. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.

Keywords: Mitral valve, repair, Mitral valve insufficiency, Child

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Original

Korean J Thorac Cardiovasc Surg 2007; 40(8): 536-545

Published online August 5, 2007

Copyright © Journal of Chest Surgery.

Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients

Hyung Tae Sim*, Dong Man Seo*, Tae Jin Yun*, Jeong-Jun Park*, Sung-Ho Jung*, Ju Yeon Uhm*, Won Kyoung Jhang*, Young Hwue Kim**, Jae Kon Ko**, In Sook Park**

Division of Pediatric Cardiac Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Division of Pediatric Cardiology, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years. The mean age was 5.3±5.3 years and the mean body weight was 20.0±16.3 kg. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were 93.3±4.6% and 76.1±8.2%, respectively. The 5-year freedom from mitral valve replacement rate was 83.6±6.7%. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.

Keywords: Mitral valve, repair, Mitral valve insufficiency, Child

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