HOMOGRAFT REPLACEMENT OF MITRAL-VALVE IN CHILDREN

Background. Recent reports have demonstrated successful early outcomes using mitral valve homografts in adults. We report our early results after homograft mitral valve replacement in 4 children with previous a trioventricular septal defects, previous placement of a prosthetic val ve, and rheumatic valvular disease. Methods. Between May 1996 and June 1997, 4 children (ages 5, 11, 13, and 15 years) underwent mitral valv e replacement with cryopreserved mitral valve homografts at our instit ution. Preoperative echocardiography confirmed moderately severe to se vere mitral regurgitation, stenosis, or both in all 4 patients. Result s. Successful homograft valve replacement was achieved in all 4 patien ts. Based on symptoms, physical examinations, and echocardiographic fo llow-up, all four homograft mitral valves are functioning well with no rmal hemodynamics. None of these patients are receiving warfarin. Foll ow-up has been limited to 10 months. Conclusions. In children requirin g mitral valve replacement, the use of mitral valve homografts offers advantages over prosthetic valves, such as the avoidance of complicati ons associated with thrombosis and anticoagulation. Homograft mitral v alve replacement is technically feasible in children with congenital a nd rheumatic heart disease and previous prosthetic valves. (Ann Thorac Surg 1998;66:849-52) (C) 1998 by The Society of Thoracic Surgeons.