Chinese expert consensus on surgical treatment of congenital heart disease (13): Congenital mitral valve malformation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 MO Xuming ¹ ,  LI Shoujun ² , Representativesof National Society for Congenital Heart Disease

1. Department of Thoracic and Cardiovascular Surgery, Children's Hospital of Nanjing Medical School, Nanjing, 210029, P.R.China;
2. Department of Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding author：

MO Xuming, Email: 373728125@qq.com; LI Shoujun, Email: drlishoujun@yahoo.com

Keywords：

Congenital heart disease; mitral valve malformation; surgical treatment; expert consensus

DOI：

10.7507/1007-4848.202009069

Video：

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To investigate the anatomical classification, diagnosis, indications, surgical methods, surgical techniques, intraoperative management, postoperative management and surgical efficacy of mitral valve malformation. Using the internationally used Delphi procedure, PubMed, Medline, The Cochrane Library, Wanfang and other databases were searched to review domestic and foreign literatures on congenital mitral valve deformity from January 1940 to February 2020, and select the ones of higher quality as evidence. In addition, with regard to the multiple disputes in the diagnosis and treatment of congenital mitral valve, experts from pediatric cardiac surgery and related disciplines have been convened for discussion for many times, and finally the following consensus has been formed to guide the clinical treatment and provide theoretical and technical guidance for the surgical treatment of congenital mitral valve malformation in China.

Citation： MO Xuming, LI Shoujun. Chinese expert consensus on surgical treatment of congenital heart disease (13): Congenital mitral valve malformation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(12): 1382-1388. doi: 10.7507/1007-4848.202009069 Copy

1.	Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56, 109 births. Incidence and natural history. Circulation, 1971, 43(3): 323-332.
2.	Ruckman RN, Van Praagh R. Anatomic types of congenitall mitral stenosis: report of 49 autopsy cases with consideration of diagnosis and surgical implications. Am J Cardiol, 1978, 42: 592-601.
3.	Carpentier A, Branchini B, Cour JC, et al. Congenital malformations of the mitral valve in children. Pathology and surgical treatment. J Thorac Cardiovasc Surg, 1976, 72: 854-66.
4.	Mitruka SN, Lamberti JJ. Congenital heart surgery nomenclature and database project: mitral valve disease. Ann Thorac Surg, 2000, 69(4 suppl): S123-S146.
5.	Moss AJ, Allen HD. Moss and Adams' heart disease in infants, children, and adolescents: including the fetus and young adult. Jama Pediatrics, 2012, 150(7): 774.
6.	Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: A report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance. J AM Soc Echocardiogr, 2017, 30: 303-371.
7.	Lepez L, Colan SD, Formmelt PC, et al. Recommendation for quanification methods during the performance of a pediatric echocardiogram: A report from a Pediatric Measurement Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J AM Soc Echocardiogr, 2010, 23: 465-495.
8.	Stellin G, Padalino M, Milanesi O, et al. Repair of congenital mitral valve dysplasia in infants and children: is it always possible? Eur J Cardiothorac Surg, 2000, 18(1): 74-82.
9.	Delmo Walter EM, Komoda T, Siniawski H, et al. Surgical reconstruction techniques for mitral valve insufficiency from lesions with restricted leaflet motion in infants and children. J Thorac Cardiovasc Surg, 2012, 143(4 Suppl): S48-S53.
10.	Delmo Walter EM, Hetzer R. Repair for congenital mitral valve stenosis. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2018, 21: 46-57.
11.	Nardi P, Pellegrino A, Scafuri A, et al. Survival and durability of mitral valve repair surgery for degenerative mitral valve disease. J Card Surg, 2011, 26(4): 360-366.
12.	Perier P, Stumpf J, Gotz C, et al. Valve repair for mitral regurgitation caused by isolated prolapse of the posterior leaflet. Ann Thorac Surg, 1997, 64(2): 445-450.
13.	Walsh MA, Benson LN, Dipchand AI, et al. Surgical repair of the mitral walve in children with dilated cardiomyopathy and mitral regurgitation. Ann Thorac Surg, 2008, 85: 2085-2088.
14.	郑景浩, 徐志伟, 刘锦纷, 等. 改良二尖瓣成形术治疗小儿二尖瓣关闭不全. 中华胸心血管外科杂志, 2011, 27(8): 459-461.
15.	孙寒松, 刘迎龙, 萧明第, 等. 婴幼儿二尖瓣关闭不全的成形术. 中华胸心血管外科杂志, 1997, 4: 18-21.
16.	Vida VL, Zanotto L, Carrozzini M, et al. Repair techniques for mitral valve insufficiency in children. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2018, 21: 41-45.
17.	史艺, 亦桐, 张雅娟, 等. 婴幼儿单纯二尖瓣关闭不全的外科中期疗效分析. 中华小儿外科杂志, 2018, 39(3): 196-199.
18.	Gazoni LM, Fedoruk LM, Kern JA, et al. A simplified approach to degenerative disease: triangular resections of the mitral valve. Ann Thorac Surg, 2007, 83(5): 1658-1564.
19.	Alfieri O, Maisamo F, de Bonis M, et al. The double-orifice technique in mitral valve repair: a simple solution for complex problems. J Thorac Cardiovasc Surg, 2001, 122(4): 674-681.
20.	Ando M, Takahashi Y. Durability of mitral valve repair performed before the age of 5 years. Circ J, 2016, 80(1): 124-129.
21.	Vricella LA, Ravekes WA, Arbustini E, et al. Simplified mitral valve repair in pediatric patients with connective tissue disorders. J Thorac Cardiovasc Surg, 2017, 53(2): 399-403.
22.	Quarti A, D’alfonso A, Colaneri M, et al. Edge-to-edge technique: is it also useful in children? J Cardiovasc Med (Hagerstown), 2009, 10(11): 848-851.
23.	Maisano F, Redaelli A, Pennati G, et al. The hemodynamic effects of double 2 orifice valve repair for mitral regurgitation: a 3D computational model. Eur J Cardio Thorac Surg, 1999, 15: 419-425.
24.	曹芳, 莫绪明, 陈俊, 等. 小儿二尖瓣双孔成形术的随访研究. 中华胸心血管外科杂志, 2017, 33(8): 456-461.
25.	Zhang G, Zhang F, Zhu M, et al. Modified edge-to-edge technique for correction of congenital mitral regurgitation in infants and children. Ann Thorac Surg, 2011, 92(4): e89-e91.
26.	Perrault LP, Moskowitz AJ, Kron IL, et al. Optimal surgical management of severe ischemic mitral regurgitation: to repair or replace? J Thorac Cadiovasc Surg, 2012, 143: 1396-1403.
27.	甘辉立, 张健群, 王胜洵, 等. 腱索折叠与人工腱索矫治二尖瓣前瓣脱垂的比较分析. 中华外科杂志, 2008, 46(22): 1727-1729.
28.	Gillinov AM, Cosgrove DM. Chordal transfer for repair of anterior leaflet prolapse. Semin Thorac Cardiovasc Surg, 2004, 16(2): 169-173.
29.	Zussa C, Polesel E, Da Col U, et al. Seven-year experience with chordal replacement with expanded polytetrafluoroethylene in floppy mitral valve. J Thorac Cardiovasc Surg, 1994, 108(1): 37-41.
30.	Suri RM, Clavel MA, Schaff HV, et al. Effect of recurrent mitral regurgitation following degenerative mitral valve repair: Long-term analysis of competing outcomes. J Am Coll Cardiol, 2016, 67(5): 488-498.
31.	Maisano F, Franzen O, Baldus S, et al. Percutaneous mitral valve interventions in the real world: early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol, 2013, 62(12): 1052-1061.
32.	Joffe DC, Jones TK, Reisman M, et al. Not for adults only: MitraClip use in a pediatric patient. EuroIntervention, 2016, 12(8): e1065-e1070.
33.	Gorenflo M, Katus HA, Bekeredjian R. Successful MitraClip^TM implantation in a 15-year-old patient with multiple prior cardiac surgeries. Cardiol Young, 2013, 23(4): 620-622.
34.	McElhinney DB, Sherwood MC, Keane JF, et al. Current management of severe congenital mitral stenosis: outcomes of transcatheter and surgical therapy in 108 infants and children. Circulation, 2005, 112(5): 707-714.
35.	Spevak PJ, Bass JL, Ben-Shachar G, et al. Balloon angioplasty for congenital mitral stenosis. Am J Cardiol, 1990, 66(4): 472-476.
36.	Schaverien MV, Freedom RM, McCrindle BW. Independent factors associated with outcomes of parachute mitral valve in 84 patients. Circulation, 2004, 109(19): 2309-2313.
37.	Yakub MA, Krishna Moorthy PS, Sivalingam S, et al. Contemporary long-term outcomes of an aggressive approach to mitral valve repair in children: is it effective and durable for both congenital and acquired mitral valve lesions? Eur J Cardiothorac Surg, 2016, 49(2): 553-560.
38.	Kalfa D, Vergnat M, Ly M, et al. A standardized repair-oriented strategy for mitral insufficiency in infants and children: midterm functional outcomes and predictors of adverse events. J Thorac Cardiovasc Surg, 2014, 148(4): 1459-1466.
39.	VanLoozen D, Jensen MA, Lutin WA, et al. Hammock mitral valve repair in infancy: operative steps toward a customized reconstruction after preoperative planning. World J Pediatr Congenit Heart Surg, 2019: 2150135118808745.
40.	Rowlatt U, Rimoldi H, Lev M. The quantitative anatomy of the normal child’s heart. Pediatr Clin North Am, 1963, 10: 499-588.
41.	Martin E, Del Nido PJ, Nathan M. Technical performance scores are predictors of midterm mortality and reinterventions following congenital mitral valve repair. Eur J Cardiothorac Surg, 2017, 52(2): 218-224.
42.	Chauvaud S, Fuzellier JF, Houel R, et al. Reconstructive surgery in congenital mitral valve insufficiency (Carpentier’s techniques): long-term results. J Thorac Cardiovasc Surg, 1998, 115: 84-93.
43.	Delmo Walter EM, Komoda T, Siniawski H, et al. Long-term surgicall outcome of mitral valve repair in infants and children with Shoe’s anomaly. Eur J Cardiothorac Surg, 2013, 43: 473-482.

1. Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56, 109 births. Incidence and natural history. Circulation, 1971, 43(3): 323-332.
2. Ruckman RN, Van Praagh R. Anatomic types of congenitall mitral stenosis: report of 49 autopsy cases with consideration of diagnosis and surgical implications. Am J Cardiol, 1978, 42: 592-601.
3. Carpentier A, Branchini B, Cour JC, et al. Congenital malformations of the mitral valve in children. Pathology and surgical treatment. J Thorac Cardiovasc Surg, 1976, 72: 854-66.
4. Mitruka SN, Lamberti JJ. Congenital heart surgery nomenclature and database project: mitral valve disease. Ann Thorac Surg, 2000, 69(4 suppl): S123-S146.
5. Moss AJ, Allen HD. Moss and Adams' heart disease in infants, children, and adolescents: including the fetus and young adult. Jama Pediatrics, 2012, 150(7): 774.
6. Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: A report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance. J AM Soc Echocardiogr, 2017, 30: 303-371.
7. Lepez L, Colan SD, Formmelt PC, et al. Recommendation for quanification methods during the performance of a pediatric echocardiogram: A report from a Pediatric Measurement Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J AM Soc Echocardiogr, 2010, 23: 465-495.
8. Stellin G, Padalino M, Milanesi O, et al. Repair of congenital mitral valve dysplasia in infants and children: is it always possible? Eur J Cardiothorac Surg, 2000, 18(1): 74-82.
9. Delmo Walter EM, Komoda T, Siniawski H, et al. Surgical reconstruction techniques for mitral valve insufficiency from lesions with restricted leaflet motion in infants and children. J Thorac Cardiovasc Surg, 2012, 143(4 Suppl): S48-S53.
10. Delmo Walter EM, Hetzer R. Repair for congenital mitral valve stenosis. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2018, 21: 46-57.
11. Nardi P, Pellegrino A, Scafuri A, et al. Survival and durability of mitral valve repair surgery for degenerative mitral valve disease. J Card Surg, 2011, 26(4): 360-366.
12. Perier P, Stumpf J, Gotz C, et al. Valve repair for mitral regurgitation caused by isolated prolapse of the posterior leaflet. Ann Thorac Surg, 1997, 64(2): 445-450.
13. Walsh MA, Benson LN, Dipchand AI, et al. Surgical repair of the mitral walve in children with dilated cardiomyopathy and mitral regurgitation. Ann Thorac Surg, 2008, 85: 2085-2088.
14. 郑景浩, 徐志伟, 刘锦纷, 等. 改良二尖瓣成形术治疗小儿二尖瓣关闭不全. 中华胸心血管外科杂志, 2011, 27(8): 459-461.
15. 孙寒松, 刘迎龙, 萧明第, 等. 婴幼儿二尖瓣关闭不全的成形术. 中华胸心血管外科杂志, 1997, 4: 18-21.
16. Vida VL, Zanotto L, Carrozzini M, et al. Repair techniques for mitral valve insufficiency in children. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2018, 21: 41-45.
17. 史艺, 亦桐, 张雅娟, 等. 婴幼儿单纯二尖瓣关闭不全的外科中期疗效分析. 中华小儿外科杂志, 2018, 39(3): 196-199.
18. Gazoni LM, Fedoruk LM, Kern JA, et al. A simplified approach to degenerative disease: triangular resections of the mitral valve. Ann Thorac Surg, 2007, 83(5): 1658-1564.
19. Alfieri O, Maisamo F, de Bonis M, et al. The double-orifice technique in mitral valve repair: a simple solution for complex problems. J Thorac Cardiovasc Surg, 2001, 122(4): 674-681.
20. Ando M, Takahashi Y. Durability of mitral valve repair performed before the age of 5 years. Circ J, 2016, 80(1): 124-129.
21. Vricella LA, Ravekes WA, Arbustini E, et al. Simplified mitral valve repair in pediatric patients with connective tissue disorders. J Thorac Cardiovasc Surg, 2017, 53(2): 399-403.
22. Quarti A, D’alfonso A, Colaneri M, et al. Edge-to-edge technique: is it also useful in children? J Cardiovasc Med (Hagerstown), 2009, 10(11): 848-851.
23. Maisano F, Redaelli A, Pennati G, et al. The hemodynamic effects of double 2 orifice valve repair for mitral regurgitation: a 3D computational model. Eur J Cardio Thorac Surg, 1999, 15: 419-425.
24. 曹芳, 莫绪明, 陈俊, 等. 小儿二尖瓣双孔成形术的随访研究. 中华胸心血管外科杂志, 2017, 33(8): 456-461.
25. Zhang G, Zhang F, Zhu M, et al. Modified edge-to-edge technique for correction of congenital mitral regurgitation in infants and children. Ann Thorac Surg, 2011, 92(4): e89-e91.
26. Perrault LP, Moskowitz AJ, Kron IL, et al. Optimal surgical management of severe ischemic mitral regurgitation: to repair or replace? J Thorac Cadiovasc Surg, 2012, 143: 1396-1403.
27. 甘辉立, 张健群, 王胜洵, 等. 腱索折叠与人工腱索矫治二尖瓣前瓣脱垂的比较分析. 中华外科杂志, 2008, 46(22): 1727-1729.
28. Gillinov AM, Cosgrove DM. Chordal transfer for repair of anterior leaflet prolapse. Semin Thorac Cardiovasc Surg, 2004, 16(2): 169-173.
29. Zussa C, Polesel E, Da Col U, et al. Seven-year experience with chordal replacement with expanded polytetrafluoroethylene in floppy mitral valve. J Thorac Cardiovasc Surg, 1994, 108(1): 37-41.
30. Suri RM, Clavel MA, Schaff HV, et al. Effect of recurrent mitral regurgitation following degenerative mitral valve repair: Long-term analysis of competing outcomes. J Am Coll Cardiol, 2016, 67(5): 488-498.
31. Maisano F, Franzen O, Baldus S, et al. Percutaneous mitral valve interventions in the real world: early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol, 2013, 62(12): 1052-1061.
32. Joffe DC, Jones TK, Reisman M, et al. Not for adults only: MitraClip use in a pediatric patient. EuroIntervention, 2016, 12(8): e1065-e1070.
33. Gorenflo M, Katus HA, Bekeredjian R. Successful MitraClip^TM implantation in a 15-year-old patient with multiple prior cardiac surgeries. Cardiol Young, 2013, 23(4): 620-622.
34. McElhinney DB, Sherwood MC, Keane JF, et al. Current management of severe congenital mitral stenosis: outcomes of transcatheter and surgical therapy in 108 infants and children. Circulation, 2005, 112(5): 707-714.
35. Spevak PJ, Bass JL, Ben-Shachar G, et al. Balloon angioplasty for congenital mitral stenosis. Am J Cardiol, 1990, 66(4): 472-476.
36. Schaverien MV, Freedom RM, McCrindle BW. Independent factors associated with outcomes of parachute mitral valve in 84 patients. Circulation, 2004, 109(19): 2309-2313.
37. Yakub MA, Krishna Moorthy PS, Sivalingam S, et al. Contemporary long-term outcomes of an aggressive approach to mitral valve repair in children: is it effective and durable for both congenital and acquired mitral valve lesions? Eur J Cardiothorac Surg, 2016, 49(2): 553-560.
38. Kalfa D, Vergnat M, Ly M, et al. A standardized repair-oriented strategy for mitral insufficiency in infants and children: midterm functional outcomes and predictors of adverse events. J Thorac Cardiovasc Surg, 2014, 148(4): 1459-1466.
39. VanLoozen D, Jensen MA, Lutin WA, et al. Hammock mitral valve repair in infancy: operative steps toward a customized reconstruction after preoperative planning. World J Pediatr Congenit Heart Surg, 2019: 2150135118808745.
40. Rowlatt U, Rimoldi H, Lev M. The quantitative anatomy of the normal child’s heart. Pediatr Clin North Am, 1963, 10: 499-588.
41. Martin E, Del Nido PJ, Nathan M. Technical performance scores are predictors of midterm mortality and reinterventions following congenital mitral valve repair. Eur J Cardiothorac Surg, 2017, 52(2): 218-224.
42. Chauvaud S, Fuzellier JF, Houel R, et al. Reconstructive surgery in congenital mitral valve insufficiency (Carpentier’s techniques): long-term results. J Thorac Cardiovasc Surg, 1998, 115: 84-93.
43. Delmo Walter EM, Komoda T, Siniawski H, et al. Long-term surgicall outcome of mitral valve repair in infants and children with Shoe’s anomaly. Eur J Cardiothorac Surg, 2013, 43: 473-482.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Chinese expert consensus on surgical treatment of congenital heart disease (13): Congenital mitral valve malformation

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