Mitral valve replacement for children with a small annulus using ATS open pivot prosthesis

The present study was conducted to review our experience of mitral valve replacement (MVR) in small children with the ATS open pivot prosthesis. Between January 1999 and March 2002, 14 patients (7 males and 7 females) underwent a total of 15 ATS MVRs; 16AP in 9, 18AP in 3, and 20AP in 3 occasions. The mean age and body weight at operation were 1.1 +/- 0.7 (range 0.2 to 2.7) years and 6.8 +/- 2.6 (range 2.8 to 12.5) kg, respectively. There were 2 early and 2 late deaths, each non-valve related. Excluding one patient, the orifice size of the prosthesis was larger than the predicted normal size of the mitral valve for the age. The postoperative Doppler echocardiogram demonstrated normal maximal flow velocity across the prosthesis. There was no morbidity among survivors except for the patient who developed a stuck and immobile valve disc 10.2 months after the operation and required re-replacement. Our experience shows that MVR with the ATS open pivot prosthesis is a promising surgical option for small children.