Clinical results of mitral valve repair by reconstructing artificial chordae tendineae in children

Objective: There are an increasing number of reports concerning mitral valv e repair by reconstructing the chordae tendineae with the use of expanded p olytetrafluoroethylene sutures in adults. However little information is ava ilable about application or results of this technique in children. Methods: Between January 1995 and December 1997, 16 children who had from moderate to severe mitral regurgitation mainly as the result of a prolapse of the an terior leaflet (age range, 5 months-12.8 years) underwent mitral valve repa ir by reconstruction of artificial chordae, Either unilateral or bilateral Kay-Reed annuloplasty was also performed to correct annular dilatation in a ll patients. Results: No operative death or morbidity was observed. Before discharge, immediate postoperative echocardiography showed less than trivia l mitral regurgitation in all patients. The follow-up was complete in all c ases by a clinical examination and serial echocardiograms, and the median f ollow-up period was 14.8 months (range, 1.3-26.4 months). There were no val ve-related events during the entire follow-up period. The degree of mitral regurgitation, estimated by echocardiography performed at recent follow-up period, was none in 5 patients, trivial in 10 patients, and mild in 1 patie nt. The diastolic and systolic dimensions of the left ventricle decreased a nd were 95.0% and 96.2% of the normal values, respectively. Conclusions: Al though further investigations and long-term results are still called for, m itral valve repair by reconstruction of the artificial chordae was found to be safe and effective even in infants and children.