Mitral valve replacement in the first 5 years of life

Introduction and objectives: Reconstructive surgery is considered the main objective in patients with congenital malformations of the mitral valve. However, in patients with severely dysplastic valves, mitral valve replacement is considered the only option. The purpose of this study is to evaluate results in the short and medium term of mitral valve replacement with mechanical prosthesis in the first 5 years of life. Methods: Data was collected on 15 patients less than 5 years of age, who underwent mitral valve replacement in our hospital between 2003 and 2012. Results: The mean age was 21.5 months and mean weight 8.2 kg. A total of 53% of the patients presented with symptoms before 6 months of age. Parachute mitral valve was the most frequent type of malformation (33%), followed by hammock mitral valve (26%). In 80% of the cases mitral valve repair was unsuccessful. The most frequent used prosthesis was St. Jude Medical No.23. The mean follow-up time was 47.9 months. As for complications, a permanent pacemaker was implanted in one patient, another patient had gastrointestinal bleeding due to anticoagulation, and another patient required another mitral valve replacement after 3 years and 4 months. Hospital mortality was 6.6%. Conclusions: Mitral valve replacement in children less than 5 years of age involves high risks. In our experience, the medium term results are satisfactory. (C) 2015 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.orglicenses/by-nc-nd14.0/).