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Mitral valve replacement using bileaflet mechanical prosthetic valve in the first year of life

  • Munetaka Masuda
  • Hideaki Kado
  • Takashi Matsumoto
  • Yutaka Imoto
  • Yuichi Shiokawa
  • Kouji Fukae
  • Daichi Ushinohama
  • Hisataka Yasui
Original Article

Abstract

Objective: The operative management and long term outcome of mitral valve replacement in infancy remain a therapeutic challenge. The selection of a prosthetic valve for this particular age group might affect the clinical outcome. Here we present our experience of mitral valve replacement in 6 infants using small bileaflet mechanical prosthetic valves.Methods: Between January 1994 and August 1997, 6 infants (their age ranged from 3 months to 11 months, and their body weight from 2978 g to 7403 g) underwent mitral valve replacement using a mechanical valve prosthesis (16 mm CarboMedics prosthetic valve in 5, and 17 mm St. Jude Medical prosthetic valve Hemodymanic Plus in 1). The preoperative morphological features of the mitral valve were stenosis in 1, regurgitation in 3, and a combination of these in 2. The prosthesis was fixed at the annulus in 3, and at the supra-annular position in 3. Anticoagulation was performed using warfarin.Results: There was no operative mortality. Postoperative catheterization revealed an acceptable wedge pressure in the pulmonary arteries, ranging from 10 to 12 mmHg. During the mean follow-up period of 36 months, late death due to residual pulmonary hypertension occurred in 1 patient at 10 months after surgery. Excluding this patient, all remaining patients are doing well with no need for repeated operation with no thromboembolic complication. The actuarial survival rate and the reoperation free rate at 70 months are 83±15% and 100%, respectively. Conclusion: Mitral valve replacement using a small size bileaflet mechanical prosthetic valves in infancy can be performed with low operative mortality and with satisfactory mid-term results.

Key words

mitral valve replacement infant mechanical prosthetic valve CarboMedics prosthetic heart valve St. Jude Medical prosthetic heart valve 

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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 2000

Authors and Affiliations

  • Munetaka Masuda
    • 1
  • Hideaki Kado
    • 1
    • 2
  • Takashi Matsumoto
    • 1
    • 2
  • Yutaka Imoto
    • 1
    • 2
  • Yuichi Shiokawa
    • 1
    • 2
  • Kouji Fukae
    • 1
    • 2
  • Daichi Ushinohama
    • 1
    • 3
  • Hisataka Yasui
    • 1
  1. 1.Department of Cardiac SurgeryKyushu University HospitalFukuokaJapan
  2. 2.Department of Cardiovascular SurgeryFukuoka Children’s HospitalFukuokaJapan
  3. 3.Department of Pediatric CardiologyFukuoka Children’s HospitalFukuokaJapan

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