Valvular & structural heart disease
Clinical and 2D/3D-Echocardiographic Determinants of Mitral Valve Reoperation in Children With Congenital Mitral Valve Disease
Authors' conclusion
Age <1 year, tethered leaflets, 2DE postoperative MR, changes in 3D-EOA and 3D-VCRA were all independently associated with MV reoperation. 3DE parameters showed a stronger association than 2DE.
Study context
- Population
- Children <18 years undergoing MV reconstruction for congenital mitral valve disease, 2002–2018
- Participants
- 206 children
- Exposure
- Clinical and 2D/3D-echocardiographic determinants of MV reoperation; 3DE vs 2DE
- Mitral stenosisn = 105
- MRn = 75
- Mixed diseasen = 26
- Outcome
- MV reoperation
Main finding
As reported in the abstract
Independent associations with MV reoperation
Hazard ratio (95% CI)
Age <1 year
2.65(1.13–6.21)
Tethered leaflets
2.00(1.05–3.82)
≥ moderate 2DE postoperative MR
4.26(2.45–7.40)
- MV reoperation required
- 64 (31%)
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Discrimination of MV reoperation: changes in 3D-EOA vs changes in mean gradients (stenotic MV) | Changes in 3D-EOA AUC 0.847 · Changes in mean gradients AUC 0.676 |
| Discrimination of MV reoperation: changes in 3D-VCRA vs 2D-VCRA (regurgitant MV) | Changes in 3D-VCRA AUC 0.969 · 2D-VCRA AUC 0.720 |
- Discrimination of MV reoperation: changes in 3D-EOA vs changes in mean gradients (stenotic MV): P = 0.006
- Discrimination of MV reoperation: changes in 3D-VCRA vs 2D-VCRA (regurgitant MV): P = 0.012
Decision-tree discrimination of MV reoperation
- <30% increase in 3D-EOA (stenotic MV): accuracy
- 80%
- <30% increase in 3D-EOA: HR
- 8.50 (95% CI 2.9-25.1)
- <40% decrease in 3D-VCRA (regurgitant MV): accuracy
- 93%
- <40% decrease in 3D-VCRA: HR
- 22.50 (95% CI 2.9-175)
Original publication
Clinical and 2D/3D-Echocardiographic Determinants of Mitral Valve Reoperation in Children With Congenital Mitral Valve Disease. JACC Adv. Published 17 July 2024. doi:10.
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