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Ann Thorac Surg 1998;66:849-852
© 1998 The Society of Thoracic Surgeons

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Original articles: Cardiovascular

Homograft replacement of mitral valve in children¹

^a Division of Cardiovascular and Thoracic Surgery, University of Illinois College of Medicine and Children’s Hospital of Illinois at St Francis Medical Center, Peoria, Illinois, USA
^b Section of Cardiology, Department of Pediatrics, University of Illinois College of Medicine and Children’s Hospital of Illinois at St Francis Medical Center, Peoria, Illinois, USA

Accepted for publication April 13, 1998.

Address reprint requests to Dr Plunkett, Pediatric Cardiac Surgery, Illinois Cardiac Surgery Associates, 515 NE Glen Oak, Suite 202, Peoria, IL 61603
e-mail: (plunk{at}ilcardiac.com)

Background. Recent reports have demonstrated successful early outcomes using mitral valve homografts in adults. We report our early results after homograft mitral valve replacement in 4 children with previous atrioventricular septal defects, previous placement of a prosthetic valve, and rheumatic valvular disease.

Methods. Between May 1996 and June 1997, 4 children (ages 5, 11, 13, and 15 years) underwent mitral valve replacement with cryopreserved mitral valve homografts at our institution. Preoperative echocardiography confirmed moderately severe to severe mitral regurgitation, stenosis, or both in all 4 patients.

Results. Successful homograft valve replacement was achieved in all 4 patients. Based on symptoms, physical examinations, and echocardiographic follow-up, all four homograft mitral valves are functioning well with normal hemodynamics. None of these patients are receiving warfarin. Follow-up has been limited to 10 months.

Conclusions. In children requiring mitral valve replacement, the use of mitral valve homografts offers advantages over prosthetic valves, such as the avoidance of complications associated with thrombosis and anticoagulation. Homograft mitral valve replacement is technically feasible in children with congenital and rheumatic heart disease and previous prosthetic valves.

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