BACKGROUND:

The 15-mm mechanical valve was approved by the FDA in March 2018. We review our experience for infants with this valve in the mitral position, focusing on outcomes and timing to repeat mitral valve replacement (MVR).

METHODS:

Between 2006-2017, 7 patients underwent 8 MVRs (1 repeat) with a 15-mm mechanical valve. Retrospective chart review was performed to examine short- and long-term outcomes.

RESULTS:

There was no operative mortality. Mean follow-up was 5.8±4.8 years (range 0.72-11.1 years). Six patients underwent a MV operation 53±39 (9-118) days prior to 15-mm MVR. All patients were on mechanical ventilatory support at time of 15-mm MVR. Mean age, body weight, and BSA at time of 15-mm MVR were 0.5±0.3 (0.2-0.9) years, 5.6±0.8 (4.8-6.6) kg and 0.29±0.03 (0.27-0.32) m², respectively. Two patients required pacemaker implantation for AV block, both after their second MVR. Two patients are well at 16 and 24 months. Four patients underwent repeat MVR due to somatic growth and patient-prosthesis mismatch. Mean time to repeat MVR was 23 months (range 6-40 months). There were 2 late deaths, one at 10 months unrelated to the valve in a child with a chromosomal abnormality. The other child had a congenital diaphragmatic hernia, early valve thrombosis, and died of multiple complications after a 4th MVR.

CONCLUSIONS:

The 15-mm MV was useful in treating MV disease in infants 2-12 months of age. This newly approved smallest available mechanical valve has a predicted mean time to replacement of 23 months in the mitral position.

Copyright © 2019. Published by Elsevier Inc.