Clinical results of commissure plication annuloplasty for mitral regurgitation in children

Purpose  We evaluated the clinical results of commissure plication annuloplasty for mitral regurgitation (MR) in children. Methods  Twenty-eight patients underwent a valve repair with commissure plication annuloplasty for MR from 1988 to 2005. The mean age was 2.7 ± 3.3 years. Several appropriate techniques were combined (cleft closure in 5 patients, chordal shortening in 2 patients, artificial chordal replacement in 4 patients, leaflet fixation in 2 patients, and so on). The mean follow-up period was 6.2 years. Results  There was one operative death (3.6%) and no late deaths. Two patients underwent a second repair 19 and 23 months after their initial repairs. The actuarial freedom from the reoperation rate was 90.4% ± 0.6% at 10 years. The freedom from moderate MR or more was shown to decrease over time, 87.8% ± 0.7% at 5 years and 78.0% ± 11.0% at 10 years. Furthermore, the 10-year freedom from mild MR or more was 56.5% ± 11.9%. A progression of MR was seen. Most of the residual or recurrent MR cases weighed less than 10 kg at operation. Conclusions  The combination of commissure plication annuloplasty and several appropriate techniques provided adequate results for MR in children. Since a progression of MR was observed, a careful follow-up is therefore needed in such cases.