title: Durability of Mitral Valve Repair Performed Before the Age of 5 Years.
abstract: BACKGROUND
  Intricate repairs performed for adult mitral valve disease may not be feasible in young children because of their small annulus, future growth and also fragile tissue.
  
  
  RESULTS
  Mitral valve repair was performed in 51 patients (1980-2011) aged younger than 5 years. The median follow-up was 3.0 (maximum, 24.2) years. Commissural annuloplasty technique was performed solely in 19 of 37 patients with coexisting cardiac disease. In 2 patients, Alfieri's edge-to-edge technique was used. Repairs for the remaining 30 patients used one of the following procedures: commissural closure (8), closure of the accessory cleft or hole (7), sliding leaflet technique (6), artificial chordal placement (6) and chordal shortening technique (3). There were 3 deaths. The postoperative degree of mitral regurgitation was mild or less in 41 patients (80.4%); 9 patients required reoperation for mitral regurgitation or stenosis. Freedom from reoperation for patients with isolated mitral regurgitation and those with other congenital heart disease at 10 years was 91.7±68.0% and 68.4±9.4%, respectively. Actuarial survival was 97.0±3.0% and 85.1±9.7%, respectively.
  
  
  CONCLUSIONS
  Excellent survival rates were achieved after mitral valve repair in patients younger than 5 years. The incidence of both reoperation and significant regurgitation was acceptable.
authors.affiliation: Department of Pediatric Cardiac Surgery, Sakakibara Heart Institute.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ando
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Takahashi
mesh_terms: D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors