Abstract
Mechanical valve replacement is often used as the therapeutic option in valvular heart surgery in children. Evidence suggests that this should change to provide optimal long-term survival for this growing population. We reviewed our current practice in valve repair in congenital heart disease and analyzed its outcomes.
A total of 90 patients (30 semilunar valve, 60 atrioventricular valve) underwent valve repair between September 2020 and December 2024. Operative data and follow-up information were gathered retrospectively. Kaplan-Meier calculations were used for survival and freedom from reoperation analysis. Cox regression analysis was used to assess risk factors for mortality (single ventricle physiology, age and weight at time of surgery, bicuspid aortic valve, and complexity of repair). Complexity of repair was defined as the application of three or more repair techniques.
Estimated survival at 12 months for semilunar and AV valve groups was 95.2% and 95%, respectively. Estimated freedom from reoperation at 12 months for repair of semilunar and AV valves was 95.8% and 95.6%, respectively. Single ventricle morphology (HR: 5.2, 95% CI 1.3-20.8; p = 0.0198) and younger age at time of surgery (HR: 0.7, 95% CI 0.6-0.9; p = 0.0223) were associated with increased risk of mortality.
Valve repair in congenital heart disease provides reliable early outcomes in this complex population. The worst outcomes are expected in patients with single ventricle requiring surgery in early life.