Mitral valve repair in children below the age of 10 years - Trouble or Success?

Abstract Background Mitral valve (MV) repair in children is challenging due to the broad spectrum of lesions and anticipated patient growth. The purpose of the study was to evaluate the outcome of MV repair in children below 10 years of age. Methods We reviewed all MV repair procedures performed in children below 10 years of age. Endpoints of the study were survival after MV repair and cumulative incidence of reoperation. Results MV repair was performed in 40 patients with congenital mitral valve disease (MVD) and in 10 patients with acquired MVD. Median age at time of repair for congenital MVD was 1.2 years [14days-9.8years] and for acquired MVD 1.9 years [10days-9.9years]. Indication for MV repair was mitral regurgitation (MR) in 31 congenital MVD patients (77.5%) and in all acquired MVD patients. In patients with congenital MVD operative mortality was 5% and late mortality was 10%. No deaths occurred in patients with acquired MVD. Patients with congenital MR showed a better, yet not significant, 6-year survival than patients with congenital mitral stenosis (85.3±8.2% vs. 60±18.2%, p=0.1). In patients with congenital MVD cumulative incidence of reoperation at 6 years was 38.6±8.3%. Conclusions In children below 10 years of age, MV repair is an effective treatment option for MVD. However, it often just delays the time to valve replacement.