Original articleCongenital heart surgerySurgical Indications and Results of Mitral Valve Repair in Pediatric Patients With Ventricular Septal Defects Accompanied by Mitral Valve Regurgitation
Section snippets
Study Population
This study protocol was approved by our institutional review board, and all procedures were performed in accordance with our institutional guidelines for the protection of patient confidentiality. The requirement for patient’s consent was waived owing to the retrospective nature of this study.
Between February 2002 and December 2012, 1,898 patients presented with VSD in two hospitals. Among them, 107 patients (5.6%, 46 males and 61 females) who showed accompanying MR during the same period were
Clinical Outcomes
The median age and body weight at surgery was 4.5 months (range, 2.3 to 9.2 months) and 6.4 kg (range, 4.8 to 8.1 kg), respectively. There were 72 patients with perimembranous type VSD, 22 patients with doubly committed juxtaarterial type VSD, 11 patients with muscular outlet type VSD, and 2 patients with total conal defect VSD.
Among the 107 pediatric VSD patients who presented with MR, 48 patients (44.9%, M:F = 20:28) required MV repair (group I): 7 patients with preoperative MR grade 1
Comment
In this study, we found that MV repair in pediatric VSD patients with MR was a feasible and procedure allowing appropriate growth potential for the MV. In addition, the preoperative dilated MV annulus and left ventricular volume was shown to be normalized after VSD closure at the latest follow-up. Furthermore, we also found that MV repair in patients with MR grade 2 showed a better likelihood of MR grade improvement than those without MV repair at the latest follow-up.
Mitral valve repair for
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Cited by (8)
Invited commentary
2015, Annals of Thoracic SurgeryPediatric Mitral Regurgitation: Standardized Repair-Oriented Strategy With Leaflet Plication
2020, Seminars in Thoracic and Cardiovascular SurgeryCitation Excerpt :Only 3 (6.5%) cases of regurgitation were attributed to isolated annular dilatation. According to these findings, we suggested an aggressive mitral repair necessary when patients showed a moderate or severe MR. Authors from Seoul confirmed that patients with significant MR who underwent MV repair showed better MR improvement than patients without MV repair.16 Experiences of different techniques of repair on various parts of the valve can be obtained from adult cardiac surgery.
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2018, Journal of Shanghai Jiaotong University (Medical Science)