Mitral valve replacement in infants and younger children

Abstract Data on mitral valve replacement (MVR) in young children is still limited. Our objective was to evaluate MVR in children below 5 years and identify factors affecting the outcomes. This retrospective study included 29 patients who had MVR from 2002 to 2020. We grouped the patients into two g...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ahmed F. Elmahrouk, Mohamed H. Mashali, Mohamed F. Ismail, Amr A. Arafat, Rawan M. Alamri, Haysam A. Baho, Mohammad S. Shihata, Ahmed A. Jamjoom
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2e0db8f18f61407fb2e4f68cc9c4c49f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2e0db8f18f61407fb2e4f68cc9c4c49f
record_format	dspace
spelling	oai:doaj.org-article:2e0db8f18f61407fb2e4f68cc9c4c49f2021-12-02T16:06:42ZMitral valve replacement in infants and younger children10.1038/s41598-021-94779-02045-2322https://doaj.org/article/2e0db8f18f61407fb2e4f68cc9c4c49f2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94779-0https://doaj.org/toc/2045-2322Abstract Data on mitral valve replacement (MVR) in young children is still limited. Our objective was to evaluate MVR in children below 5 years and identify factors affecting the outcomes. This retrospective study included 29 patients who had MVR from 2002 to 2020. We grouped the patients into two groups according to their age: age ≤ 24 months (n = 18) and > 24 months (n = 11). Primary cardiac diagnoses were Shone complex (n = 7; 24%), isolated congenital mitral valve abnormality (n = 11; 38%), and complete atrioventricular septal defect (n = 3; 10%). The median age was 19 month (25th–75th percentile: 11–32) and 59% were females (n = 17). The hemodynamic lesions were mitral regurgitation in 66%, mitral stenosis in 10%, and combined mitral stenosis and regurgitation in 24% of the patients. St. Jude mitral valve was the most common valve implanted (n = 19, 66%), followed by CarboMedics in 21% of the patients (n = 6). The mitral valve was implanted in the supra-annular position in 6 cases (21%). Preoperative and operative data were comparable between both groups. There was no association between valve size and position with postoperative heart block (P > 0.99, for both). The median follow-up duration was 19.4 months (8.6–102.5). Nine patients had mitral valve reoperation, six had MVR, and three had clot removal from the mitral valve. There was no effect for age group on reoperation (SHR 0.89 (95% CI 0.27–2.87), P = 0.84). Valve size significantly affected reoperation (SHR 0.39 (95% CI 0.18–0.87), P = 0.02). The supra-annular position was associated with an increased risk of reoperation (SHR 3.1 (95% CI 1.003–9.4), P = 0.049). There was no difference in survival according to the age (Log-rank P = 0.57) or valve size (Log-rank P = 0.66). Mitral valve replacement in children is associated with low morbidity and mortality. The risk of reoperation could be affected by the valve size and position rather than the age.Ahmed F. ElmahroukMohamed H. MashaliMohamed F. IsmailAmr A. ArafatRawan M. AlamriHaysam A. BahoMohammad S. ShihataAhmed A. JamjoomNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ahmed F. Elmahrouk Mohamed H. Mashali Mohamed F. Ismail Amr A. Arafat Rawan M. Alamri Haysam A. Baho Mohammad S. Shihata Ahmed A. Jamjoom Mitral valve replacement in infants and younger children
description	Abstract Data on mitral valve replacement (MVR) in young children is still limited. Our objective was to evaluate MVR in children below 5 years and identify factors affecting the outcomes. This retrospective study included 29 patients who had MVR from 2002 to 2020. We grouped the patients into two groups according to their age: age ≤ 24 months (n = 18) and > 24 months (n = 11). Primary cardiac diagnoses were Shone complex (n = 7; 24%), isolated congenital mitral valve abnormality (n = 11; 38%), and complete atrioventricular septal defect (n = 3; 10%). The median age was 19 month (25th–75th percentile: 11–32) and 59% were females (n = 17). The hemodynamic lesions were mitral regurgitation in 66%, mitral stenosis in 10%, and combined mitral stenosis and regurgitation in 24% of the patients. St. Jude mitral valve was the most common valve implanted (n = 19, 66%), followed by CarboMedics in 21% of the patients (n = 6). The mitral valve was implanted in the supra-annular position in 6 cases (21%). Preoperative and operative data were comparable between both groups. There was no association between valve size and position with postoperative heart block (P > 0.99, for both). The median follow-up duration was 19.4 months (8.6–102.5). Nine patients had mitral valve reoperation, six had MVR, and three had clot removal from the mitral valve. There was no effect for age group on reoperation (SHR 0.89 (95% CI 0.27–2.87), P = 0.84). Valve size significantly affected reoperation (SHR 0.39 (95% CI 0.18–0.87), P = 0.02). The supra-annular position was associated with an increased risk of reoperation (SHR 3.1 (95% CI 1.003–9.4), P = 0.049). There was no difference in survival according to the age (Log-rank P = 0.57) or valve size (Log-rank P = 0.66). Mitral valve replacement in children is associated with low morbidity and mortality. The risk of reoperation could be affected by the valve size and position rather than the age.
format	article
author	Ahmed F. Elmahrouk Mohamed H. Mashali Mohamed F. Ismail Amr A. Arafat Rawan M. Alamri Haysam A. Baho Mohammad S. Shihata Ahmed A. Jamjoom
author_facet	Ahmed F. Elmahrouk Mohamed H. Mashali Mohamed F. Ismail Amr A. Arafat Rawan M. Alamri Haysam A. Baho Mohammad S. Shihata Ahmed A. Jamjoom
author_sort	Ahmed F. Elmahrouk
title	Mitral valve replacement in infants and younger children
title_short	Mitral valve replacement in infants and younger children
title_full	Mitral valve replacement in infants and younger children
title_fullStr	Mitral valve replacement in infants and younger children
title_full_unstemmed	Mitral valve replacement in infants and younger children
title_sort	mitral valve replacement in infants and younger children
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2e0db8f18f61407fb2e4f68cc9c4c49f
work_keys_str_mv	AT ahmedfelmahrouk mitralvalvereplacementininfantsandyoungerchildren AT mohamedhmashali mitralvalvereplacementininfantsandyoungerchildren AT mohamedfismail mitralvalvereplacementininfantsandyoungerchildren AT amraarafat mitralvalvereplacementininfantsandyoungerchildren AT rawanmalamri mitralvalvereplacementininfantsandyoungerchildren AT haysamabaho mitralvalvereplacementininfantsandyoungerchildren AT mohammadsshihata mitralvalvereplacementininfantsandyoungerchildren AT ahmedajamjoom mitralvalvereplacementininfantsandyoungerchildren
_version_	1718384894107713536

Mitral valve replacement in infants and younger children

Ejemplares similares