Mitral valve replacement in infants and younger children

Autor:	Mohamed H. Mashali, Haysam Baho, Ahmed A. Jamjoom, Amr A. Arafat, Mohamed Ismail, Rawan M. Alamri, Ahmed F. Elmahrouk, Mohammad Shihata
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Male medicine.medical_specialty Heart block medicine.medical_treatment Science Hemodynamics Regurgitation (circulation) 030204 cardiovascular system & hematology Paediatric research Article 03 medical and health sciences 0302 clinical medicine Mitral valve medicine Humans Mitral Valve Stenosis cardiovascular diseases Retrospective Studies Cardiac device therapy Heart Valve Prosthesis Implantation Mitral regurgitation Multidisciplinary business.industry Mitral valve replacement Infant Retrospective cohort study medicine.disease Cardiovascular biology Surgery Stenosis medicine.anatomical_structure 030228 respiratory system Child Preschool cardiovascular system Mitral Valve Medicine Female business
Zdroj:	Scientific Reports, Vol 11, Iss 1, Pp 1-8 (2021) Scientific Reports
ISSN:	2045-2322
Popis:	Data on mitral valve replacement (MVR) in young children is still limited. Our objective was to evaluate MVR in children below 5 years and identify factors affecting the outcomes. This retrospective study included 29 patients who had MVR from 2002 to 2020. We grouped the patients into two groups according to their age: age ≤ 24 months (n = 18) and > 24 months (n = 11). Primary cardiac diagnoses were Shone complex (n = 7; 24%), isolated congenital mitral valve abnormality (n = 11; 38%), and complete atrioventricular septal defect (n = 3; 10%). The median age was 19 month (25th–75th percentile: 11–32) and 59% were females (n = 17). The hemodynamic lesions were mitral regurgitation in 66%, mitral stenosis in 10%, and combined mitral stenosis and regurgitation in 24% of the patients. St. Jude mitral valve was the most common valve implanted (n = 19, 66%), followed by CarboMedics in 21% of the patients (n = 6). The mitral valve was implanted in the supra-annular position in 6 cases (21%). Preoperative and operative data were comparable between both groups. There was no association between valve size and position with postoperative heart block (P > 0.99, for both). The median follow-up duration was 19.4 months (8.6–102.5). Nine patients had mitral valve reoperation, six had MVR, and three had clot removal from the mitral valve. There was no effect for age group on reoperation (SHR 0.89 (95% CI 0.27–2.87), P = 0.84). Valve size significantly affected reoperation (SHR 0.39 (95% CI 0.18–0.87), P = 0.02). The supra-annular position was associated with an increased risk of reoperation (SHR 3.1 (95% CI 1.003–9.4), P = 0.049). There was no difference in survival according to the age (Log-rank P = 0.57) or valve size (Log-rank P = 0.66). Mitral valve replacement in children is associated with low morbidity and mortality. The risk of reoperation could be affected by the valve size and position rather than the age.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::16d705ba3235a11da9c8003c26622449 https://doaj.org/article/2e0db8f18f61407fb2e4f68cc9c4c49f Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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