Transcatheter Mitral Valve-in-Valve Implantation in Pediatric Patients

ABSTRACT Back Ground Transcatheter implantation of Edward's valve within the bioprosthetic mitral valve is an established method of treatment in adults. However, it is not well studied in the pediatric age group. Methods Transcatheter mitral valve in valve implantation (TMVI) was attempted in four symptomatic pediatric patients with dysfunctional mitral valve bioprosthesis implanted at an earlier stage due to severe mitral valve stenosis or regurgitation. We reviewed our experience with mitral valve implantation in this cohort. Results The mean age and weight of the patients at the time of the procedure were 11.4 years (Range 10-14) and 36 kg (Range 31 – 44), respectively. The transmitral mean gradient dropped from a mean of 19.75 mmHg (range 15-22) to a mean of 1 mmHg (range 0-3) after the procedure. The mean fluoroscopy time was 55.25 minutes (Range 40-72), and the mean hospital length of stay was 4 days (Range 3-7). The patients’ functional class improved from NYHA class IV to I during the follow-up period. Conclusion TMVI can be safely performed for dysfunctional bioprosthetic mitral valves in the pediatric age group with favorable early and mid-term outcomes. It can offer a viable alternative in patients with high surgical risk or deemed not fit for conventional surgery. However, we still recommend a long-term study of this approach in a large cohort multicenter study.