An analysis of the effect of mitral valvuloplasty in the treatment of children with mitral insufficiency

Abstract:

Objective：To investigate the effect of mitral valvuloplasty in the treatment of children with mitral insufficiency. Methods：A retrospective analysis was performed on the clinical data of 135 children（55 males and 80 females） who had undergone a mi－tral valvuloplasty in Children’s Hospital of Chongqing Medical University from July 1，2008 to July 1，2018. The surgical ap－proaches included mitral commissurotomy（90 cases），annuloplasty（13 cases），cleft suture（29 cases），double-orifice valve repair（20 cases），shortening of chordae tendineae（5 cases），and triangular resection（5 cases）. Concomitant intracardiac anomalies were treated simultaneously if present. The paired t-test was used to evaluate the effect of the operation by comparing the following preopera－tive and postoperative results：degree of regurgitation，left atrial diameter（LAD），left ventricular end-diastolic diameter（LVDd），left ventricular end-systolic diameter（LVDs），and left ven－tricular ejection fraction（LVEF）. Results：All of the 135 chil－dren had a successful operation，and no death occurred during the operation. The in-hospital mortality rate was 5.2%，and the reoperation rate was 2.3%；125 children remained in the clinic follow-up，with a loss to follow-up rate of 8.8%；the mean fol－low-up duration was （18.2±15.2） months. After the operation，there were significant reductions in the mean values of LAD，LVDd，and LVDs[（20.0±5.8） mm，（33.7±6.3） mm，and （21.6±4.9） mm，respectively，P=0.000]，and a significant increase in LVEF [（68.7±4.6）%，P=0.000]；82.5% of the children had their regurgitation reduced to a moderate or lower degree. Conclusion：Mitral valvuloplasty has a definitive effect in the treatment of children with mitral insufficiency with few complications observed，which makes it the optimal surgical approach for the disease；other concomitant intracardiac anomalies can be simultaneously treated if pre－sent，with a good outcome to be expected.