Division of Cardiac Surgery, The Children's Heart Clinic and Children's Minnesota, Minneapolis, MN, USA; Division of Cardiovascular Surgery, Children's Minnesota, Minneapolis, MN, USA; Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Rochester, MN, USA.
Division of Cardiac Surgery, The Children's Heart Clinic and Children's Minnesota, Minneapolis, MN, USA; Division of Cardiovascular Surgery, Children's Minnesota, Minneapolis, MN, USA; Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Rochester, MN, USA.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2023;26:75-80. doi: 10.1053/j.pcsu.2023.01.001. Epub 2023 Jan 16.
Mitral valve replacement (MVR) in the very young is an imposing clinical challenge. Early and late mortality risk is substantial, severe adverse events are common, and redo mitral valve replacement is inevitable. Therapeutic options are limited. In the older infant with an annulus of 17mm or larger, mechanical MVR is associated with low risk of mortality and predictable durability. For the very young with annular hypoplasia, bovine jugular vein conduit MVR appears to offer equivalent or better early outcomes with the possibility of subsequent valve expansion, potentially prolonging the interval to redo MVR. Experience with cylinder MVR and other forms of surgeon-manufactured MVR is quite limited, and there is currently no information on late outcomes or durability.
在非常年幼的患者中进行二尖瓣置换术（MVR）是一项艰巨的临床挑战。早期和晚期死亡率风险很高，严重不良事件很常见，并且需要再次进行二尖瓣置换术。治疗选择有限。对于环径为 17mm 或更大的大龄婴儿，机械 MVR 与低死亡率风险和可预测的耐用性相关。对于环形发育不良的非常年幼的患者，牛颈静脉管 MVR 似乎提供了等效或更好的早期结果，并且有可能随后进行瓣膜扩张，从而可能延长再次进行 MVR 的间隔时间。关于圆柱 MVR 和其他形式的外科医生制造的 MVR 的经验非常有限，目前尚无关于晚期结果或耐用性的信息。
