Our Summary

This research paper revisits past experiences of mitral valve (a heart valve) repair in children using artificial chordae (replacement heart strings). The authors looked back at cases from January 2011 to May 2019 for children under 18 who had this procedure. They studied how well the kids did after surgery, specifically checking if they needed another operation, if the valve was functioning properly, and if there was any severe leakage of the valve.

A total of 30 children were included in the study, half had simple heart valve issues and half had more complex issues. Over the course of follow-ups (ranging from 3 to 97 months), two kids needed another operation and seven experienced problems with the valve function. One year after the operation, all children were free from needing another operation. By 8 years, around 91% were still free from another operation. However, by the 5th year, only about 62% of children were free from valve dysfunction.

When comparing children with simple heart issues to those with more complex ones, all children with simple issues were free from valve dysfunction by the 5th year, while only about 33% of children with complex issues were. Additionally, children over 12 years old had better outcomes than those under 12.

In conclusion, this kind of heart valve repair in children using artificial chordae gives acceptable results, particularly in children with less complicated heart issues and those aged over 12 years.

FAQs

  1. What is the success rate of mitral valve repair with artificial chordae replacement in children?
  2. How do the outcomes of mitral valve repair with artificial chordae replacement differ between children with simple lesions and those with complex lesions?
  3. How does the age of the patient impact the outcome of mitral valve repair with artificial chordae replacement?

Doctor’s Tip

A doctor might tell a patient about mitral valve replacement to follow up with regular check-ups and screenings to monitor the function of the replaced valve and to catch any potential issues early on. It is also important for the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall heart health and reduce the risk of future complications.

Suitable For

Patients who are typically recommended for mitral valve replacement include those with severe mitral valve regurgitation or stenosis, congenital heart defects affecting the mitral valve, and those who have failed previous mitral valve repair procedures. This study specifically focuses on children who underwent mitral valve repair with artificial chordae replacement, showing acceptable outcomes in this population. It is important to consider the complexity of the lesion and the age of the patient when determining the most appropriate treatment approach.

Timeline

Before mitral valve replacement:

  1. Patient is diagnosed with mitral valve disease, such as mitral regurgitation or mitral stenosis.
  2. Patient undergoes various diagnostic tests, such as echocardiogram, to assess the severity of the condition.
  3. Patient may undergo medical management to control symptoms and slow disease progression.
  4. Surgery is recommended when symptoms become severe or when the condition starts to affect the patient’s quality of life.

After mitral valve replacement:

  1. Patient undergoes mitral valve repair with artificial chordae replacement surgery.
  2. Patient is monitored closely post-surgery for any complications or issues.
  3. Follow-up appointments are scheduled to assess the function of the artificial chordae and the overall success of the surgery.
  4. Freedom from mitral valve reoperation and dysfunction is estimated through regular check-ups and tests.
  5. Patients with simple lesions and older age tend to have better outcomes compared to patients with complex lesions and younger age.
  6. Overall, the early and intermediate outcomes of mitral valve repair with artificial chordae replacement in children are considered acceptable, with optimal outcomes seen in certain patient populations.

What to Ask Your Doctor

  1. What is my diagnosis and why do I need a mitral valve replacement?
  2. What are the different options for mitral valve replacement and why is artificial chordae replacement recommended for me?
  3. What are the potential risks and complications associated with mitral valve replacement surgery?
  4. What is the expected recovery time and rehabilitation process after the surgery?
  5. How often will I need follow-up appointments and monitoring after the surgery?
  6. What lifestyle changes or restrictions will I need to follow after the surgery?
  7. What is the long-term outlook for mitral valve replacement with artificial chordae in children?
  8. What are the factors that may affect the success of the surgery and my overall outcome?
  9. Are there any specific medications I will need to take after the surgery?
  10. Are there any support groups or resources available for patients undergoing mitral valve replacement surgery?

Reference

Authors: Dun Y, Xing J, Zhao D, Su W, Luo G, Yang K. Journal: Gen Thorac Cardiovasc Surg. 2021 Oct;69(10):1383-1391. doi: 10.1007/s11748-021-01597-2. Epub 2021 Mar 3. PMID: 33656741