Risk of infective endocarditis after hybrid melody mitral valve replacement in infants: the French experience.

Autor:	Padovani P; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France.; INSERM, Nantes Université, CHU Nantes, Nantes, France., Jalal Z; Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France.; U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France.; Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France., Fouilloux V; Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France., Benbrik N; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France.; INSERM, Nantes Université, CHU Nantes, Nantes, France., Grunenwald C; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France.; INSERM, Nantes Université, CHU Nantes, Nantes, France., Thambo JB; Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France.; U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France.; Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France., Aldebert P; Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France., Tagorti M; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France.; INSERM, Nantes Université, CHU Nantes, Nantes, France., Roubertie F; Electrophysiology and Heart Modeling Institute, IHU Liryc, Fondation Bordeaux Université, Bordeaux, France.; U1045, INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France.; Department of Pediatric Cardiology, FHU PRECICARE, CHU Bordeaux, Bordeaux, France., Baron O; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France., Ovaert C; Department of Pediatric Cardiology, FHU PRECICARE, AP-HM, Timone Infant Hospital Marseille, Marseille, France.; Marseille Medical Genetics, INSERM U1251, Aix-Marseille Université, Marseille, France., Ly M; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France., Baruteau AE; Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France.; INSERM, Nantes Université, CHU Nantes, Nantes, France.; Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France.; Nantes Université, INRAE, UMR 1280, PhAN, Nantes, France.
Jazyk:	angličtina
Zdroj:	Interdisciplinary cardiovascular and thoracic surgery [Interdiscip Cardiovasc Thorac Surg] 2024 Mar 29; Vol. 38 (4).
DOI:	10.1093/icvts/ivae046
Abstrakt:	Objectives: Surgical management of mitral valve disease is challenging in infants <1 year old. We aimed at reviewing the French experience with Melody mitral valve replacement in critically ill infants. Methods: A retrospective cohort study reporting the French experience with Melody mitral valve replacement. Results: Seven symptomatic infants [complete atrioventricular septal defect (n = 4, Down syndrome: n = 3), hammock valve (n = 3)] underwent Melody mitral valve replacement [age: 3 months (28 days to 8 months), weight: 4.3 kg (3.2-6.4 kg)] because of severe mitral valve regurgitation (6) or mixed valve disease (1) and 14 mm (11-16 mm) mitral valve annulus. In 2 patients whose valve was felt irreparable, Melody mitral valve replacement was performed straightaway. The others underwent 2 (1-3) previous attempts of valve repair; 3 were on extracorporeal membrane oxygenation. Melody mitral valve replacement led to competent valve and low gradient [3 mmHg, (1-4 mmHg)]. One patient died 3 days post-implant from extracorporeal membrane oxygenation-related stroke. Of the 6 discharged home patients, 3 (50%) were readmitted for a definite diagnosis (1) or high suspicion (2) of infective endocarditis, of which 2 died. Over the follow-up, 1 underwent balloon expansions of the valve at 9- and 16-months post-implant, and mechanical mitral valve replacement at 2 years; another is currently planned for transcatheter Melody valve dilation. Conclusions: Melody mitral valve replacement may be considered in selected infants with small mitral valve annulus as an alternative to mechanical mitral valve replacement. Our experience highlights a high-risk of late infective endocarditis that deserves further consideration. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Databáze:	MEDLINE
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