Leaflet foldoplasty of mitral valvuloplasty for mitral regurgitation in children
- VernacularTitle:瓣叶折叠在小儿二尖瓣成形中的应用
- Author:
Lei QI
1
;
Kai MA
1
;
Benqing ZHANG
1
;
Kunjing PANG
1
;
Fengqun MAO
1
;
Sen ZHANG
1
;
Guanxi WANG
1
;
Zicong FENG
1
;
Yang YANG
1
;
Jianhui YUAN
1
;
Shoujun LI
1
Author Information
1. Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China
- Publication Type:Journal Article
- Keywords:
Congenital mitral regurgitation;
mitral valvuloplasty;
leaflet foldoplasty;
standardized strategy
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(04):421-426
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report the short-term outcomes of a standardized, simplified and reproducible strategy of mitral valvuloplasty (MVP), which was focused on leaflet foldoplasty and anatomic anomalies of congenital mitral regurgitation (MR). Methods Consecutive 74 patients who underwent MVP by our standardized strategy in our institution from 2016 to 2018 were included retrospectively. There were 30 males and 44 females with a median age of 18.5 (6-146) months and weight of 15.4 (7-51) kg. Results Anatomic anomalies of MR included: (1) subvalvular apparatus: 72 (97.3%) patients with mal-connected chordae tendineae, 31 (41.9%) with absent chordae tendineae and 14 (18.9%) with fused or dysplastic papillary muscle; (2) leaflet: 10 (13.5%) patients with cleft of anterior leaflet, 61 (82.4%) with leaflet prolapse including 56 (91.8%) with anterior leaflet prolapse; (3) annulus: 71 (95.9%) patients with annular dilatation. Leaflet foldoplasty was performed in 61 (82.4%) patients with leaflet prolapse. All patients were successfully discharged and 4 (5.4%) patients were with moderate MR. The follow-up time was 22.0 (9.1-41.8) months. During the follow-up period, 3 patients had moderate MR and 1 patient had reoperation for severe MR. All patients were in normal cardiac function with a mean left ventricular ejection fraction of 66.0%±6.1%. In addition, the mean left ventricular end-diastolic dimension was 31.8±6.0 mm, which was significant smaller than that before the operation (t=6.090, P<0.000 1). Conclusion The standardized leaflet foldoplasty with resection of mal-connected chordae tendineae and posterior annuloplasty technique is safe and feasible with favorable short-term outcomes in MR patients.
