Surgical management of mitral valve disease in neonates and infants is challenging.
When repair is no longer feasible, replacement may become inevitable, but should only
be considered as an option of last resort due to the remarkably high rate of associated
morbidity and mortality. Mechanical valves are the preferred choice in large annuli,
while stented conduits seem promising in smaller ones. In patients with a preoperative
mitral valve annulus equal or larger than 15-16 mm, an intra-annular placement of
the smallest mechanical valve available should be attempted. In patients with smaller
annuli, the placement of a stented valved conduit seems to display a lower mortality
risk. Supra-annular implantation of prostheses should be reserved for exceptional
cases and to those familiar with this technique because of the high rate of associated
complications.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Seminars in Thoracic & Cardiovascular Surgery: Pediatric Cardiac Surgery AnnualAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Long-term survival after mitral valve replacement in children aged <5 years: a multi-institutional study.Circulation. 2001; 104 (Sep 18(12 Suppl 1): I143-147)
- Predictors of prosthesis survival, growth, and functional status following mechanical mitral valve replacement in children aged <5 years, a multi-institutional study.Circulation. 2003; 108 (Sep 9Suppl 1:II): 174-179
- Durability of mitral valve repair performed before the age of 5 years.Circ J Off J Jpn Circ Soc. 2016; 80: 124-129
Sabiston and Spencer Surgery of the Chest - 9th Edition [Internet]. [cited 2020 Aug 16]. Available from: https://www.elsevier.com/books/sabiston-and-spencer-surgery-of-the-chest/sellke/978-0-323-24126-7
- Surgical treatment of congenital mitral valve disease: midterm results of a repair-oriented policy.J Thorac Cardiovasc Surg. 2008; 135 (Jun 1e4): 1313-1321
- Mitral valve replacement in infants and children 5 years of age or younger: evolution in practice and outcome over three decades with a focus on supra-annular prosthesis implantation.J Thorac Cardiovasc Surg. 2008; 136 (Oct961.e1-3): 954-961
- Results after mitral valve replacement with mechanical prostheses in young children.J Thorac Cardiovasc Surg. 2010; 139 (May 1e2): 1189-1196
- Outcomes of Mechanical mitral valve replacement in children.Ann Thorac Surg. 2019; 107: 143-150
- Long-term follow-up after mitral valve replacement in childhood: poor event-free survival in the young child.Eur J Cardiothorac Surg. 2007; 31 (May 1): 860-865
- Mitral valve replacement in children.J Heart Valve Dis. 2003; 12 (Jandiscussion 30): 25-29
- Multiple left-sided stenotic lesions: outcomes after mitral valve surgery. Arguments for abandoning the eponym “Shone syndrome”.Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 2020; (May 23): 567-573
- Mid-term outcomes of congenital mitral valve surgery: Shone's syndrome is a risk factor for death and reintervention.Interact Cardiovasc Thorac Surg. 2017; 25 (01): 734-739
- Intra-annular mitral valve replacement in neonates and infants.J Thorac Cardiovasc Surg. 2015; 149 (Jane1): 390-392
- Mitral valve replacement using a handmade construct in an infant.Interact Cardiovasc Thorac Surg. 2017; 24 (01): 639-640
- Surgical Atrioventricular valve replacement with melody valve in infants and children.Circ Cardiovasc Interv. 2018; 11 (e007145)
- Stented bovine jugular vein graft (Melody valve) for surgical mitral valve replacement in infants and children.J Thorac Cardiovasc Surg. 2014; 148 (Oct): 1443-1449
- Surgical mitral valve replacement with the Melody valve in infants and children: the Italian experience [Internet].EuroIntervention. 2020; ([citedAug 19]. Available from: https://eurointervention.pcronline.com/article/surgical-mitral-valve-replacement-with-the-melody-valve-in-infants-and-children-the-italian-experience)
- Melody valve for mitral valve replacement.Oper Tech Thorac Cardiovasc Surg. 2014; 19 (Dec 1): 454-463
- Modification of a stented bovine jugular vein conduit (melody valve) for surgical mitral valve replacement.Ann Thorac Surg. 2012; 94 (Octe97-98)
- Extending the limits for mitral valve replacement in low-weight infants using a stented bovine jugular vein graft.J Thorac Cardiovasc Surg. 2015; 150 (Sep): 729-730
- Revisiting prosthesis choice in mitral valve replacement in children: Durable alternatives to traditional bioprostheses.J Thorac Cardiovasc Surg [Internet]. 2020; (May 31 [cited 2020 Aug 22];0(0). Available from: https://www.jtcvs.org/article/S0022-5223(20)31281-2/abstract)
- Age and body surface area dependency of mitral valve and papillary apparatus parameters: assessment by real-time three-dimensional echocardiography.Eur J Echocardiogr. 2008; 10 (Aug 4): 287-294
- Mitral valve replacement with the 15-mm mechanical valve: a 20-year multicenter experience.Ann Thorac Surg. 2020; (Jan 18)
- Use of stented bovine pericardial valve for surgical mitral valve replacement in infants.J Thorac Cardiovasc Surg. 2016; 151 (Mare51-2)
- Concept of an expandable cardiac valve for surgical implantation in infants and children.J Thorac Cardiovasc Surg. 2016; 152: 1514-1523
- Modified technique for Melody valve implantation in the mitral position.J Thorac Cardiovasc Surg. 2018; 156 (Sep 1): 1190-1191
- Preserving the V-engine shape of the left ventricle with Melody mitral valve replacement in small children.J Thorac Cardiovasc Surg. 2017; 153: 151-152
- Left ventricular pseudoaneurysm after replacement of a Melody valve in the left atrioventricular valve position.JTCVS Tech. 2020; 4 (Dec 1): 248-250
- Mechanical mitral valve replacement: a multicenter study of outcomes with use of 15- to 17-mm prostheses.Ann Thorac Surg. 2020; (Jun 7)
- The Ross II procedure: pulmonary autograft in the mitral position.Ann Thorac Surg. 2004; 78 (Oct): 1489-1495
- Pulmonary autograft mitral valve replacement (ross ii): long-term follow-up of a US center.World J Pediatr Congenit Heart Surg. 2018; 9: 645-650
- Mitral valve replacement in pediatrics using an extracellular matrix cylinder valve: a case series.Pediatr Cardiol. 2020; (Jun 30)
- Porcine small intestine submucosa cylinder valve for mitral and tricuspid valve replacement.J Thorac Cardiovasc Surg. 2017; 154 (Sepe57–9)
- Decellularized bovine pericardial mitral valve in a neonatal marfan patient.Ann Thorac Surg. 2020; 110 (Octe293–4)
- Novel annular and subvalvular enlargement in congenital mitral valve replacement.Ann Thorac Surg. 2016; 102 (Sepe277–9)
- The ordeal of left atrioventricular valve replacement in children under 1 year of age.Interact Cardiovasc Thorac Surg. 2017; 25 (01): 317-322
- Mechanical mitral valve replacements in the pediatric population.Ann Thorac Surg. 2020; (Aug 31)
- Clinical course and hemodynamic observations after supraannular mitral valve replacement in infants and children.J Am Coll Cardiol. 1997; 29 (Apr 1): 1089-1094
- Complications of supra-annular mitral valve placement in infants.Heart. 2005; 91 (June48)
- Supra-annular mitral valve implantation in very small children.J Card Surg. 2015; 30 (Feb): 185-189
- Supra-annular mitral valve replacement in children.Ann Thorac Surg. 2011; 92 (Dec): 2221-2229
- A novel technique of supra-annular mitral valve replacement.Ann Thorac Surg. 2008; 86 (Sep 1): 1033-1035
- Outcomes of supra-annular mechanical atrioventricular valve replacement with polytetrafluoroethylene graft in infants and children.Pediatr Cardiol. 2020; 41 (Mar): 607-614
- Mitral annulargrowth in children following early mechanical mitral valve replacement.World J Pediatr Congenit Heart Surg [Internet]. 2010; (Jul 20 [cited 2020 Jul 3]; Available from: https://journals.sagepub.com/doi/10.1177/2150135110371487)
- Age less than two years is not a risk factor for mortality after mitral valve replacement in children.Ann Thorac Surg. 2011; 91 (Apr): 1228-1234
- Long-term outcome after annular mechanical mitral valve replacement in children aged less than five years.Ann Thorac Surg. 2010; 90 (Nov 1): 1570-1576
- Mitral valve surgery in neonates, infants, and children: surgical approach, outcomes, and predictors.Semin Thorac Cardiovasc Surg. 2020; 32 (Sep 1): 541-550
- Mitral valve replacement in children: predictors of long-term outcome.Ann Thorac Surg. 2003; 76 (Sep 1): 853-859
- Mitral valve replacement using bileaflet mechanical prosthetic valve in the first year of life.Jpn J Thorac Cardiovasc Surg. 2000; 48 (Oct 1): 643-647
- Mitral valve surgery in the first year of life.Pediatr Cardiol. 2020; 41 (Feb): 334-340
- Annulus upsizing for mitral valve re-replacement in children.J Thorac Cardiovasc Surg. 2013; 146 (Aug): 347-351
- Evolution of mitral valve replacement in children: a 40-year experience.Ann Thorac Surg. 2012; 93 (Feb): 626-633
- Outcomes and associated risk factors for mitral valve replacement in children.Eur J Cardiothorac Surg. 2011; 40 (Sep 1): 543-551
- Mechanical mitral valve replacement in children: an update.Transl Pediatr. 2019; 8 (Oct 9455-457-457)
Whitlock RP, Sun JC, Fremes SE, et al. Antithrombotic and thrombolytic therapy for valvular disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb 1;141(2, Supplement):e576S-e600S.
- Oral anticoagulation therapy in children: successfully controlled by self-management.Heart Surg Forum. 2004; 7 (Jul 1E321-325)
- Outcomes of mitral valve replacement in children: a competing-risks analysis.J Thorac Cardiovasc Surg. 2004; 128 (Nov): 703-709
- Systemic atrioventricular valve replacement in patients with functional single ventricle.Semin Thorac Cardiovasc Surg. 2019; 31: 526-534
Article info
Footnotes
Conflicts of Interest: Yves d'Udekem is a consultant for MSD and Actelion. He also is a NHMRC Clinician Practitioner Fellow [1082186]. Christian Brizard is a consultant for Anteris Australia.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
