The efficacy of mitral valve surgery in children with dilated cardiomyopathy and severe mitral regurgitation

John P. Breinholt, Charles D. Fraser, William J. Dreyer, Anthony C. Chang, E. O'Brian Smith, Jeffrey S. Heinle, E. Dean McKenzie, Sarah K. Clunie, Jeffrey Towbin, Susan W. Denfield

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Severe mitral regurgitation predicts poor outcomes in adults with left ventricular dysfunction. Frequently, adult patients now undergo initial mitral valve surgery instead of heart transplant. Pediatric data are limited. This study evaluates the efficacy of mitral valve surgery for severe mitral regurgitation in children with dilated cardiomyopathy. This is a single-institution experience in seven children (range, 0.5-10.9 years) with severe mitral regurgitation and dilated cardiomyopathy who underwent mitral valve surgery between January 1988 and February 2005, with follow-up to January 2006. Children with dilated cardiomyopathy had a depressed fractional shortening preoperatively (24.4% ± 6.1%) that remained depressed (22.9% ± 7.6%) 1.3 ± 1.2 years after surgery (p = 0.50). Left ventricular end-diastolic (6.5 ± 1.5 to 4.8 ± 1.8 z-scores, p < 0.01) and end-systolic (6.8 ± 1.5 to 5.5 ± 2.1 z-scores, p < 0.05) dimensions improved. Hospitalization frequency had a median decrease of 6.0 hospitalizations per year (p < 0.02). Three patients were transplanted 0.2, 2.4, and 3.5 years after surgery. There was no perioperative mortality. Mitral valve surgery in children with dilated cardiomyopathy was performed safely and improved symptoms, stabilizing ventricular dysfunction in most patients. Mitral valve surgery should be considered prior to heart transplant in children with dilated cardiomyopathy and severe mitral regurgitation.

Original languageEnglish (US)
Pages (from-to)13-18
Number of pages6
JournalPediatric Cardiology
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

Fingerprint

Dilated Cardiomyopathy
Mitral Valve Insufficiency
Mitral Valve
Hospitalization
Transplants
Ventricular Dysfunction
Left Ventricular Dysfunction
Thoracic Surgery
Pediatrics
Mortality

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Breinholt, J. P., Fraser, C. D., Dreyer, W. J., Chang, A. C., O'Brian Smith, E., Heinle, J. S., ... Denfield, S. W. (2008). The efficacy of mitral valve surgery in children with dilated cardiomyopathy and severe mitral regurgitation. Pediatric Cardiology, 29(1), 13-18. https://doi.org/10.1007/s00246-007-9050-x

The efficacy of mitral valve surgery in children with dilated cardiomyopathy and severe mitral regurgitation. / Breinholt, John P.; Fraser, Charles D.; Dreyer, William J.; Chang, Anthony C.; O'Brian Smith, E.; Heinle, Jeffrey S.; Dean McKenzie, E.; Clunie, Sarah K.; Towbin, Jeffrey; Denfield, Susan W.

In: Pediatric Cardiology, Vol. 29, No. 1, 01.01.2008, p. 13-18.

Research output: Contribution to journalArticle

Breinholt, JP, Fraser, CD, Dreyer, WJ, Chang, AC, O'Brian Smith, E, Heinle, JS, Dean McKenzie, E, Clunie, SK, Towbin, J & Denfield, SW 2008, 'The efficacy of mitral valve surgery in children with dilated cardiomyopathy and severe mitral regurgitation', Pediatric Cardiology, vol. 29, no. 1, pp. 13-18. https://doi.org/10.1007/s00246-007-9050-x
Breinholt, John P. ; Fraser, Charles D. ; Dreyer, William J. ; Chang, Anthony C. ; O'Brian Smith, E. ; Heinle, Jeffrey S. ; Dean McKenzie, E. ; Clunie, Sarah K. ; Towbin, Jeffrey ; Denfield, Susan W. / The efficacy of mitral valve surgery in children with dilated cardiomyopathy and severe mitral regurgitation. In: Pediatric Cardiology. 2008 ; Vol. 29, No. 1. pp. 13-18.
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