title: Age less than two years is not a risk factor for mortality after mitral valve replacement in children.
abstract: BACKGROUND
  Outcomes for mitral valve replacement (MVR) in the pediatric population are generally reported as poor, particularly in patients less than 2 years old. We compared long-term morbidity and mortality associated with MVR between patients less than 2 years old and patients 2 to 18 years old.
  
  
  METHODS
  We evaluated pediatric patients undergoing MVR from March 1990 to November 2007 at our institution. Morbidity and mortality was compared between patients less than 2 years and patients 2 to 18 years old. Primary endpoints measured were postoperative survival, long-term survival, reoperation, cerebrovascular accident or transient ischemic attack, and significant bleeding events.
  
  
  RESULTS
  Forty-five patients underwent 54 MVRs. Median age was 3.1 years; 18 patients were under 2 years. Median follow-up time was 5.4 years. There was no statistically significant difference between long-term or short-term survival between the two age groups, with 30-day survival of 89% (younger patients) versus 100% (older patients), and 10-year survival of 82% (younger patients) versus 85% (older patients). Freedom from reoperation for the younger age group was 40% at 10 years versus 96% for the older patients, p = 0.003.
  
  
  CONCLUSIONS
  In our population, there was no statistically significant difference in survival between patients less than 2 years and patients 2 to 18 years. In children undergoing MVR, age less than 2 years remains a risk factor for reoperation but not for mortality.
authors: Division of Pediatric Cardiology and Cardiothoracic Surgery at Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors: Daniela Y
authors: DY
authors: Rafii
authors: Ryan R
authors: RR
authors: Davies
authors: Sheila J
authors: SJ
authors: Carroll
authors: Jan M
authors: JM
authors: Quaegebeur
authors: Jonathan M
authors: JM
authors: Chen
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors