Mitral Valve Repair Techniques in Neonates and Infants

Abstract

Mitral valve repair is often preferred over replacement due to the preservation of native valve function, allowing for somatic growth and resulting in fewer complications and reoperations. Although there are no randomized trials comparing repair and replacement specifically in this age group, retrospective studies still indicate better long-term survival and lower reoperation rates with repair. While neonates and infants experience higher mortality rates compared to older children, freedom from re-intervention is durable in the survivors and matches that of older children. Especially compression suture annuloplasty and chordal replacement using Gore-Tex sutures have shown favorable outcomes, but the rarity of the condition makes it challenging to train new surgeons. Utilizing detailed video documentation could help bridge this educational gap. While advancements in materials for valve repair in neonates and infants have been slow, emerging options like new materials that grow with the patient offer potential for future innovation. In complex cases such as Shone's syndrome, new techniques, including an-bloc replacement of the aorta and mitral valve, may improve outcomes.