儿童孤立性二尖瓣反流标准化成形术中探查结果及术后中期随访结果分析OA北大核心CSTPCD

Objective To preliminarily investigate the etiological characteristics of isolated mitral regur-gitation in children,intraoperative findings,and mid-term follow-up outcomes after standardized mitral valve re-pair.Methods A retrospective analysis was conducted on 42 cases of isolated mitral regurgitation in children who underwent standardized mitral valve repair at the Pediatric Cardiac Surgery Center,Fuwai Hospital,Chinese Academy of Medical Sciences,from January 2020 to December 2023.There were 16 males and 26 females with a median age at surgery of 76.1(range:45.2 to 109.1)months.The primary endpoints were all-cause mortali-ty and mitral valve dysfunction,and the secondary endpoints were severe perioperative complications.Re-sults Intraoperative exploration revealed that,besides annular dilation,the most common anatomical cause of isolated mitral regurgitation was subvalvular deformity,observed in 39 cases(39/42,92.9％).During a me-dian follow-up of 17.1(range:11.9 to 23.7)months,there were no severe perioperative complications or deaths.Three patients developed significant mitral regurgitation postoperatively,among whom 2 underwent me-chanical mitral valve replacement,while 1 continues under medical management.A preoperative and follow-up self-comparison was conducted on the 40 patients who did not undergo mechanical valve replacement.The re-sults showed that postoperative left ventricular ejection fraction[68.5(64.0,72.0)％vs.65.0(61.5,69.5)％]and left ventricular end-diastolic diameter[+2.6(+1.1,+4.5)vs.-0.1(-0.9,+1.5)]were significantly lower than preoperative values(P＜0.05),and the severity of mitral regurgitation was signifi-cantly improved compared to preoperative levels(Z=-5.715,P＜0.05).The rates of freedom from major endpoint events at 6 months,1 year,and 3 years postoperatively were 97.62％,95.05％,and 81.47％,re-spectively.Conclusions Anatomical abnormalities causing isolated mitral regurgitation predominantly in-volve subvalvular structures.Subvalvular exploration and management are crucial technical aspects of mitral valve repair.