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J Thorac Cardiovasc Surg 2005;129:336-342
© 2005 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Midterm results of mitral valve repair with artificial chordae in children

^a Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan
^b Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan

Read at the Eighty-fourth Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, April 25-28, 2004.

Received for publication April 20, 2004; revisions received October 14, 2004; accepted for publication October 27, 2004.

^* Address for reprints: Hideaki Kado, MD, Department of Cardiovascular Surgery, Fukuoka Children's Hospital, 2-5-1 Tojinmachi, Chuo-ku, Fukuoka City, Fukuoka 810-0063, Japan (E-mail: kado.h{at}fukuoka-child.jp).

OBJECTIVE: We have used artificial chordal replacement with expanded polytetrafluoroethylene sutures for mitral valve repair in children and reported favorable early clinical results. In this article we evaluate the midterm results of mitral valve repair with expanded polytetrafluoroethylene sutures in 39 children.

METHODS: From April 1995 through September 2003, mitral valve repair with chordal replacement using expanded polytetrafluoroethylene sutures was performed in 39 patients. In all patients the preoperative grade of mitral regurgitation was moderate or more because of prolapse of the anterior mitral leaflet. The mean age and body weight at the time of the operation were 4.7 ± 5.3 years (range, 1 month to 17.8 years) and 14.4 ± 12.2 kg (range, 3.9-54.4 kg), respectively. The number of expanded polytetrafluoroethylene sutures ranged from 1 to 3 (mean, 1.4). The mean follow-up period and body weight at the latest follow-up were 5.0 ± 2.3 years (range, 1.1-8.5 years) and 25.7 ± 16.4 kg (range, 6.9-73 kg), respectively.

RESULTS: There were no operative or late deaths. Only one patient required mitral valve replacement, which occurred 17 days after repair. Two patients underwent redo mitral valve repair 2 and 5 years after initial repair, respectively. The actuarial freedom from reoperation at 5 and 8 years was 94.8% and 89.5%, respectively. At the latest follow-up, trivial or less mitral regurgitation was observed in 33 (84.6%) patients.

CONCLUSIONS: Mitral valve repair with expanded polytetrafluoroethylene sutures in children demonstrated favorable midterm outcome. The procedure is safe and effective, with potential for patients' growth.

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