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Acta pediátrica de México
versão On-line ISSN 2395-8235versão impressa ISSN 0186-2391
Resumo
DILIZ-NAVA, HS et al. Mitral valve replacement in infants and children. Acta pediatr. Méx [online]. 2017, vol.38, n.1, pp.10-16. ISSN 2395-8235. https://doi.org/10.18233/apm1no1pp10-161319.
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.
OBJECTIVE:
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.
Palavras-chave : mitral valve; congenital mitral valve disease; heart valve prosthesis implantation.