Supra‐Annular Mitral Valve Implantation in Very Small Children. Issue 2 (29th December 2014)

• Record Type: Journal Article
• Authors: Giordano, Raffaele; Cantinotti, Massimiliano; Pak, Vitali; Arcieri, Luigi; Poli, Vincenzo; Assanta, Nadia; Moschetti, Riccardo; Murzi, Bruno
• Is Part Of: Journal of cardiac surgery. Volume 30:Issue 2(2015:Feb.)
• Page Start: 185
• Page End: 189
• Publication Date: 2014-12-29
• Subjects: Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.12501
• Languages: English
• ISSNs: 0886-0440

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>A<sc>BSTRACT</sc></title> <sec id="jocs12501-sec-0001" sec-type="section"> <title>Objective</title> <p>Mitral valve replacement (MVR) is a surgical option when mitral valvuloplasty is not feasible/successful. This study reviews our experience with MVR in very young children.</p> </sec> <sec id="jocs12501-sec-0002" sec-type="section"> <title>Methods</title> <p>From July 2004 to January 2014, seven children (mean age 13.3 ± 11.2 months; range 4 months to 35 months; mean body weight 6.0 ± 2.2 kg) underwent MVR with a mechanical prosthesis in the supra‐annular position. To provide better exposure in the left atrium, we performed in all but one case a biatrial transeptal incision according to Guiraudon. Six patients had congenital defects of the mitral valve and one had rheumatic. Six patients had undergone previous cardiosurgical procedures.</p> </sec> <sec id="jocs12501-sec-0003" sec-type="section"> <title>Results</title> <p>All patients were implanted with a CarboMedics (CarboMedics, Austin, TX, USA) mechanical prosthesis. Mean prosthesis size was 19.0 ± 3.1 mm (range 16 to 25). There were no cases of operative or late mortality. At follow‐up (mean 67.1 ± 34.8 months; range 25 to 108 months) two patients (28.6%) required reoperation both for thrombotic pannus formation over the disc at two and three months from first operation, respectively; only in one case was replacement necessary.</p> </sec> <sec id="jocs12501-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Supra‐annular MVR may be considered a feasible secondary surgical option in children with a small annulus when mitral valvuloplasty is unsuccessful or unsuitable. Early and mid‐term outcomes are acceptable but complications are not uncommon, especially related to thrombotic events. doi: 10.1111/jocs.12501 <italic>(J Card Surg 2015;30:185–189)</italic></p> </sec> </abstract>