Mitral valve repair with artificial chordae replacement in children: a single-center experience

Objectives To summarize the experience of mitral valve (MV) repair with artificial chordae replacement in children, and analyze early and intermediate outcomes. Methods From January 2011 to May 2019, all patients (< 18 years) who received MV repair with artificial chordae replacement were retrospectively reviewed. Freedom from MV reoperation, MV dysfunction, moderate or severe MR were estimated by the Kaplan-Meier curve and log-rank test. Results A total of 30 patients were included in this study. According to our definition, 15 patients had simple lesions and 15 patients had complex lesions. During 36 months' follow-up (range 3-97 months), two patients received MV reoperation and seven patients developed MV dysfunction, including six patients with moderate or severe MR and one patient with mitral stenosis. Freedom from MV reoperation at 1, 5 and 8 years were 100%, 91.3% and 91.3%, respectively. And freedom from MV dysfunction at 1, 3 and 5 year were 96.0%, 77.1% and 61.8%, respectively. Five-year freedom from MV dysfunction showed significant differences between patients with simple lesions and patients with complex lesions (100% vs 32.7%, log-rank P = 0.008), and between patients aged less than 12 years and patients aged more than 12 year (33.5% vs 90.0%, log-rank P = 0.025). Conclusion The early and intermediate outcomes of mitral valve repair with artificial chordae replacement were acceptable in children, and the outcomes were optimal in patients with simple lesions, and patients aged more than 12 years.