Effectiveness of mitral valve repair in congenital mitral valve malformation in infancy

Objective: In infants every effort should be made to preserve the native mitral valve (MV). The aim of the study was to analyze effectiveness of MV repair regarding to preservation of native valve in infancy.

Method: Between 2005 and 2013, 28 infants with congenital MV malformation underwent MV repair. 17 and 11 pts had predominantly MS and MR respectively. 18 pts (64%) had associated lesions which required 22 concomitant procedures. Median age at primary surgery was 8 months.

Results: There was no death within the median follow-up (FU) time of 2.8 years (2-84 months). In MS group significant decrease (p=0.004) of mean gradient was achieved. In MR group significant decrease (p<0.002) of regurgitation was achieved. Freedom from redo was 62% at 2 years of FU with no difference between MS and MR. Freedom from MV replacement was 75% at 3 years with no difference between MS and MR. All pts are in sinus rhythm. During follow-up, there were no clinically apparent neurological problems. All patients are doing well, and growth is adequate.

Conclusions: Reparative surgery of congenital MV malformation in infancy offers excellent survival benefit and encouraging mid-term functional outcomes, preserving more than 75% of native MV's.