Infant Mitral Valve Replacement: Current State of the Art

• Published in: Seminars in thoracic and cardiovascular surgery. Pediatric cardiac surgery annual Vol. 26; pp. 75 - 80
• Main Authors: Overman, David M., Moga, Francis X., Stephens, Elizabeth H., Dearani, Joseph A., MacIver, Robroy H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2023
• Subjects: Congenital heart disease; Mechanical mitral valve replacement; Mitral valve; Outcomes; Mitral valve; MVR; Congenital heart disease; BJVC; LVOT; Outcomes; BJVC-MVR; Mechanical mitral valve replacement; PCCC; LVOTO; AVSD; C-MVR; M-MVR; ePTFE; OPTN
• ISSN: 1092-9126
• DOI: 10.1053/j.pcsu.2023.01.001

Mitral valve replacement (MVR) in the very young is an imposing clinical challenge. Early and late mortality risk is substantial, severe adverse events are common, and redo mitral valve replacement is inevitable. Therapeutic options are limited. In the older infant with an annulus of 17mm or larger, mechanical MVR is associated with low risk of mortality and predictable durability. For the very young with annular hypoplasia, bovine jugular vein conduit MVR appears to offer equivalent or better early outcomes with the possibility of subsequent valve expansion, potentially prolonging the interval to redo MVR. Experience with cylinder MVR and other forms of surgeon-manufactured MVR is quite limited, and there is currently no information on late outcomes or durability.