Supra-Annular Mitral Valve Replacement in an Infant With Infective Endocarditis

Yamauchi, Sanae; Iwai, Shigemitsu; Tominaga, Yasunori; Kugo, Yosuke; Hasegawa, Masumi; Kayatani, Futoshi; Takahashi, Kyoko; Aoki, Hisaaki; Kawata, Hiroaki

doi:10.1016/j.athoracsur.2017.08.042

Cited by 5 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We employed the Dacron conduit that would be softer and provide better hemodynamics than the Gore-Tex conduit. The prosthetic valves were implanted to the conduit follow suturing the conduit wall to the annulus, which may provide convenience for the surgeon to implant a larger valve in a smaller space, also reducing the occurrence of periprosthetic leakage [23]. The avoidance of directly suturing on mitral valve annulus or left atrial wall may contribute to eliminating excessive traction of the left atrial tissue, left circumflex coronary artery, and pulmonary vein orifices.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

Yuan

Lü

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

Background The outcomes of mitral valve replacement (MVR) in pediatrics especially in the patients weighing less than 10 kg are not always favorable. This study aimed to measure long-term outcomes of MVR in our institution. Methods Nine young children weighing less than 10 kg underwent MVR with mechanical prostheses were enrolled in this retrospectively study. Kaplan–Meier survival analysis was used for the prediction of freedom from death and adverse events. Chi-square test was performed to compare outcomes for patients with different ratios of mechanical prosthesis size and body weight. Fourteen related literatures were also reviewed to support our study. Results All patients received bileaflet mechanical prostheses replacement. The surgical technique varied among the patients with prostheses implanted in the intra-annular (n = 5), supra-annular (n = 1), or with a Dacron conduit segment in the supra-annular position (n = 3). The valve size/weight ratio ranged from 2.11 to 5.00. There were two early death and one late death post-operation. The mean follow-up period was 80.67 ± 63.37 months, the transvalvular gradient was 10.5 ± 1.76 mmHg (range 8 to 12) and the peak gradient of LVOT was 5.00 ± 0.64 mmHg. One (11.1%) patient underwent an immediate revision MVR after initial MVR due to the periprosthetic leak. No patients required surgical reintervention or permanent pacemaker placement during long-term follow-up. Conclusions The tailored surgical strategy utilized for MVR in infants resulted in reliable valve function and excellent survival. Although revision is inevitable due to somatic growth, the bileaflet mechanical prostheses displayed appropriate durability.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

Yuan

Lü

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…We employed the Dacron conduit that would be softer and provide better hemodynamics than the Gore-Tex conduit. The prosthetic valves were implanted to the conduit follow suturing the pipe to the annulus, which may provide convenience for the surgeon to implant a larger valve in a smaller space, also reducing the occurrence of periprosthetic leakage [16]. The technique of intermittent suture would preserve the growth potential and may provide the possibility for the replacement of a larger mitral valve in the future.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

Lü

Tang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The techniques of mitral valve repair（MVP ) in children have been well established and provide acceptable long-term outcomes; certain pediatric patients require mitral valve replacement (MVR) after an unsuccessful MVP. The outcomes of MVR in pediatrict especially in the patients weighning are not always favorable. This study aimed to measure long-term outcomes of MVR at our institute.Methods: Nine young children weighing less than 10 kg underwent MVR from November 2006 to April 2019. Their mean age was 11.88 ± 11.29 months and mean body weight was 6.83 ± 2.56 kg at the time of initial MVR. Four patients (44.4%) had undergone at least one previous cardiac surgical procedure prior to MVR. Several surgical techniques were used to implant mechanical bileaflet prostheses.Results: All patients received bileaflet mechanical prostheses. The surgical technique varied among the patients with valves implanted intra-annularly (n = 5), supra-annularly (n=1), or supra-annularly with a tilt (n = 3). The valve size/weight ratio ranged from 2.11 to 5.00. After a mean follow-up period of 80.67 ± 63.37 months, the survival rate was 66.67%. One (11.1%) patient underwent an immediate revision MVR after initial MVR for the preprosthetic leak. No patients required surgical reintervention for the development of left ventricular outflow tract obstruction or permanent pacemaker placement during long-term follow-up.Conclusions: The tailored surgical strategy utilized for MVR in infants resulted in reliable valve function and excellent survival. Although revision is inevitable due to somatic growth, the bileaflet mechanical prostheses displayed appropriate durability.

show abstract

“…Jong Soo Woo successfully implanted a 16-mm mechanical valve in the supra-annular position by suturing it into a short PTFE graft that was then sutured to the native annular in 2008 [Sung 2008]. Hiroaki Kawata used this method to insert a 16-mm mechanical valve with short-segment PTFE graft in a female neonate at 40 weeks [Yamauchi 2018]. We sutured 16-mm and 19-mm mechanical valves with PTFE grafts and implanted them into the two patients.…”

Section: Discussionmentioning

confidence: 99%

Supra-Annular Mitral Valve Replacement in Infants with Congenital Mitral Valve Disease

Yuan

Wu²,

Yang³

et al. 2019

HSF

View full text Add to dashboard Cite

Mitral valve replacement in infants is rare and causes a relatively high mortality, especially for patients under the age of 1. Supra-annular valve replacement is a viable technique for infants with a small valve annulus. Here, we report two infants who underwent mitral valve replacement via the supra-annular technique. The age and body weight of these babies were 2 months and 3 months and 4.1 kg and 4.7 kg, respectively. Aortic mechanical valves were reversely implanted with a short segment of PTFE graft. The purpose of this strategy was to insert a larger mechanical valve and delay resternotomy. A two-year follow-up exam showed normal ventricular function without mechanical valve-related complications. This method is useful in treating neonates and infants. Although the technique of mitral valve repair has improved over several decades, mitral valve replacement still is necessary at times. In neonates and infants with a small annulus, implantation of commercially available prosthetic valves in the annular position can be a challenge, and an age less than 1 year is a risk factor for early death [Selamet 2008]. Supra-annular mitral valve replacement (SMVR) is an alternative when a traditional annular implantation is not feasible [Sung 2008]. Herein, we report the cases of two patients, who underwent SMVR with a follow-up after two years.

show abstract

Supra-Annular Mitral Valve Replacement in an Infant With Infective Endocarditis

Cited by 5 publications

References 8 publications

Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

Long-term outcomes of mitral valve replacement in patients weighing less than 10 kg

Supra-Annular Mitral Valve Replacement in Infants with Congenital Mitral Valve Disease

Contact Info

Product

Resources

About