Objective: We analyzed the long-term results of mitral valve repair in children.

Methods: We reviewed clinical records of 139 children(<18 years) who underwent mitral valve repair between 1988 and 2007. Patients with AVSD, single ventricle, or AV discordance were excluded. Median age was 2.3 years(2 months-17.6 years). Mitral regurgitation was predominant in 125 patients(90%), and mitral stenosis was predominant in 14 patients(10%). Associated cardiac lesions were present in 111 patients(80%). Various surgical techniques were used according to the functional and pathologic findings of mitral valve.

Results: There was no early death. Median follow-up was 8 years(2 months-20 years). Twenty six patients required 29 mitral reoperations, and 11 of these required mitral valve replacement. At 15 years, freedom from reoperation and mitral valve replacement was 77% and 90%, respectively. Diagnosis of MS and valve status on discharge(MR grade ≥3 or MS gradient ≥10mmHg) were significant risk factors for reoperation. There were 3 late deaths, and overall survival was 97% at 15 years. Among 136 survivors, 111 patients(82%) underwent echocardiography during follow-up. The degree of MR decreased significantly and only 5 patients showed MR grade ≥3. The degree of MS decreased significantly and median MS gradient was 2.8mmHg(0-10mmHg). All survivors remain in NYHA class I or II.

Conclusions: Mitral valve repair in children showed excellent survival, acceptable reoperation rate, and satisfactory valve function at long-term follow-up. Residual valve dysfunction was a significant risk factor for reoperation, but re-repair was successful in more than half of the patients who underwent reoperation.