Supra-Annular Mitral Valve Replacement in Two Infants

Yoshiya Shigehisa＊	Tomoyuki Matsuba＊	Hideaki Kanda＊
Yuki Ogata＊	Yutaka Imoto＊

（Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan）

When mitral valve dysfunction occurs in infants and mitral valve repair is difficult, mitral valve replacement（MVR）is required. However, commercially available prosthetic heart valves can be too large to implant in infants with a small annulus. In these children, the technique of supra-annular MVR is useful. Here we report two cases of supra-annular MVR, which were performed using an expanded polytetrafluoroethylene（ePTFE）graft as a skirt for a prosthetic valve. This method has been previously reported by Sung et al. The first case was a 16-month-old, 6.7-kg male infant who suffered from Shone● syndrome, mitral stenosis（MS）with a parachute mitral valve, coarctation of the aorta（CoA), and ventricular septal defect（VSD). MS progressed after CoA repair and VSD closure and a supra-annular MVR was performed. The second case was a 5-month-old, 4.9-kg female infant who suffered from polysplenia, intermediate atrioventricular septal defect（AVSD), and severe left atrioventricular valve regurgitation. AVSD repair was performed at the age of 3 months. However, valve stenosis and regurgitation gradually progressed postoperatively and consequently, a supra-annular MVR was performed. Postoperative prosthetic valve function was good in both cases. We believe that this method of performing supra-annular MVR is useful for infants with a small annulus.

 

Jpn. J. Cardiovasc. Surg. 47:157-161（2018）

Keywords：supra-annular mitral valve replacement;small annulus;infant;Shone complex