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2017, Number 1

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Acta Pediatr Mex 2017; 38 (1)

Mitral valve replacement in infants and children

Diliz-Nava HS, Pérez-Juárez F, Araujo-Martínez A, García-Benítez L, Tamariz-Cruz O, Palacios-Macedo-Quenot A

Language: Spanish
References: 17
Page: 10-16
PDF size: 560.58 Kb.


ABSTRACT

Background: Mitral valve replacement in children is a rare procedure associated to unique clinical and technical difficulties. Recent studies suggest a better outcome on short and long term after MVR.
Objetive: The aim of this study is to analyze the experience with mitral valve replacement at the National Institute of Pediatrics (NIP) in Mexico City.
Methods: On a retrospective basis, we reviewed the charts of pediatric patients who underwent MVR at the NIP from August 2002 to August 2012. Primary endpoints measured were mortality, anticoagulation complications and long-term outcomes.
Results: Twelve patients underwent mitral valve replacement. Median age of 11.5 years, three patients were under 5 years. Mitral dysfunction was considered congenital in 11 and rheumatic in 1. The hemodynamic manifestation was mitral insufficiency in 8 cases, combined mitral stenosis and mitral insufficiency in 3, and pure stenosis in one. Mean left ventricular ejection fraction was 63% prior to surgery. Mechanical prosthesis was placed in 11 cases. One patient received a biological prosthesis. Two patients died in the immediate postoperative period, with a 30-day survival of 83%. No mortality was reported in the follow up period. One patient had an episode of mild gastrointestinal bleeding and two patients had atrial arrhythmia. No thromboembolic events. There were no re-interventions. Median follow up time was 3 years.
Conclusion: In our conditions and population, mitral valve replacement seems a good option for patients who cannot benefit from repair, with acceptable results on a short and long term follow up.


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