title: Surgical indications and results of mitral valve repair in pediatric patients with ventricular septal defects accompanied by mitral valve regurgitation.
abstract: BACKGROUND
  Ventricular septal defects (VSDs) can be accompanied by mitral regurgitation (MR) owing to chronic volume overload or mitral valve (MV) abnormalities. This study investigates the surgical indications, results, and natural course of pediatric VSD patients with MR.
  
  
  METHODS
  One hundred seven patients (median age, 4.5 months; median body weight, 6.2 kg; M:F = 46:61) who had VSD with accompanying MR between 2002 and 2012 were retrospectively analyzed and classified into two groups: group I, MV repair group; group II, no MV repair group.
  
  
  RESULTS
  Of 107 patients, 48 patients (44.9%) required MV repair. Annular dilatation (n = 46) and anterior MV prolapse (n = 35) were the representative MV diseases in group I and their incidences were higher than in group II (n = 26 and n = 6, respectively; both p < 0.001). Increased preoperative z values of MV annulus, and mean diastolic and systolic left ventricle internal diameters were observed in group I (1.9 ± 1.0, 3.4 ± 1.3, and 3.1 ± 1.3, respectively) in comparison with group II (1.0 ± 0., 2.6 ± 1.7, and 2.3 ± 1.7, respectively; p < 0.001, p = 0.02, and p = 0.024, respectively). Posteromedial commissure annuloplasty in 23 patients and posterior annuloplasty in 19 patients were the most commonly used techniques to repair the MV; no reoperations were performed owing to MR. In group I, all patients showed an MR grade of 2 or less during the follow-up period. In group II, all patients showed the same or lower MR degree.
  
  
  CONCLUSIONS
  Mitral valve repair in pediatric VSD patients with accompanying MR is a feasible and durable procedure with growth potential.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Republic of Korea.
authors.forename: Woo Sung
authors.initials: WS
authors.lastname: Jang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul; National University College of Medicine, Seoul, Republic of Korea. Electronic address: woonghan@snu.ac.kr.
authors.forename: Woong-Han
authors.initials: WH
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Republic of Korea.
authors.forename: Joon Yong
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Children's Hospital, Pusan National University College of Medicine, Gyeongnam, Republic of Korea.
authors.forename: Kwangho
authors.initials: K
authors.lastname: Choi
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul; National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Choi
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Republic of Korea.
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, Republic of Korea.
authors.forename: Gun-Jik
authors.initials: GJ
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul; National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Ryul
authors.initials: JR
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome