Late left ventricular function after surgery for children with chronic symptomatic mitral regurgitation

• Published in: Circulation (New York, N.Y.) N.Y.), 1997-12, Vol.96 (12), p.4280-4285
• Main Authors: KRISHNAN, U. S, GERSONY, W. M, BERMAN-ROSENZWEIG, E, APFEL, H. D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Cardiology. Vascular system; Child; Child, Preschool; Chronic Disease; Echocardiography; Endocardial and cardiac valvular diseases; Heart; Humans; Infant; Medical sciences; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - physiopathology; Mitral Valve Insufficiency - surgery; Myocardial Contraction - physiology; Postoperative Period; Risk Factors; Stroke Volume; Time Factors; Ventricular Function, Left - physiology
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.96.12.4280

The use of quantitative echocardiography has been emphasized in optimizing timing of surgery in adult patients with mitral regurgitation to avoid irreversible left ventricular dysfunction. In contrast, surgery for infants and children is often delayed until the appearance of severe symptoms because of the patient's size and anticoagulation requirements and the possible need for early reoperation. The purpose of this study was to determine long-term ventricular function after mitral valve surgery in symptomatic children and to analyze risk factors for adverse outcome. Thirty-three patients (0.5 to 19 years old) operated on for mitral regurgitation as a single hemodynamically significant lesion were studied. All but 3 had medically refractory symptoms. One patient died during surgery, and 32 were followed for 0.3 to 17.1 years (mean, 4.5 years). The mean preoperative left ventricular shortening fraction was 0.38+/-0.09. Successful mitral valvuloplasty or replacement was documented by long-term normalization of end-diastolic dimensions. Early postoperative shortening fraction was significantly reduced (0.28+/-0.1, P