Clinical results of mitral valve repair by reconstructing artificial chordae tendineae in children.

Abstract

There are an increasing number of reports concerning mitral valve repair by reconstructing the chordae tendineae with the use of expanded polytetrafluoroethylene sutures in adults. However, little information is available about application or results of this technique in children. Between January 1995 and December 1997, 16 children who had from moderate to severe mitral regurgitation mainly as the result of a prolapse of the anterior leaflet (age range, 5 months-12.8 years) underwent mitral valve repair by reconstruction of artificial chordae. Either unilateral or bilateral Kay-Reed annuloplasty was also performed to correct annular dilatation in all patients. No operative death or morbidity was observed. Before discharge, immediate postoperative echocardiography showed less than trivial mitral regurgitation in all patients. The follow-up was complete in all cases by a clinical examination and serial echocardiograms, and the median follow-up period was 14.8 months (range, 1.3-26.4 months). There were no valve-related events during the entire follow-up period. The degree of mitral regurgitation, estimated by echocardiography performed at recent follow-up period, was none in 5 patients, trivial in 10 patients, and mild in 1 patient. The diastolic and systolic dimensions of the left ventricle decreased and were 95.0% and 96.2% of the normal values, respectively. Although further investigations and long-term results are still called for, mitral valve repair by reconstruction of the artificial chordae was found to be safe and effective even in infants and children.