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You are here: Contents > 2012 > Volume 21 Number 5 September 2012 > TRIPLE VALVE SURGERY > Triple Valve Repair in Children with Rheumatic Heart Disease: Long-Term Experience

Triple Valve Repair in Children with Rheumatic Heart Disease: Long-Term Experience

Patrick O. Myers, Mustafa Cikirikcioglu, Cécile Tissot, Jan T. Christenson, Maurice Beghetti, Afksendiyos Kalangos

Division of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland, Department of Cardiac Surgery, Children’s Hospital Boston & Harvard Medical School, Boston, USA, Pediatric Cardiology Unit, Children’s Hospital and Geneva University Hospitals, Geneva, Switzerland

Background and aim of the study: Triple valve replacement has poor early and long-term results, particularly in children, and few data are available on triple valve repair. Herein are reported the single-center, long-term results of combined aortic, mitral, and tricuspid valve repair in rheumatic children.
Methods: Ten children (mean age 12 ± 3 years) with severe rheumatic aortic, mitral, and tricuspid regurgitation underwent triple valve repair over a 17-year period, using a tailored cusp extension to repair the aortic valve, and ring annuloplasty and Carpentier’s techniques to repair the mitral and tricuspid valves.
Results: There were no early deaths. During a median follow up of 58 months (range: 3 months to 16 years), no late death occurred and four patients (40%) required reoperation at a median of three years

(range: 2.7 to 12 years). Reoperations included one for mitral valve replacement, one for aortic valve replacement, and two for aortic and mitral valve replacements. Freedom from reoperation was 100% at one year, 63 ± 17% at three, five, and 10 years, and 47 ± 19% at 15 years.
Conclusion: In this particularly challenging patient group, triple valve repair provided satisfactory initial and mid-term results, with a high burden of reoperation in the long term, allowing a median of three years of growth and subsequent placement of a larger valve at the time of actual valve replacement. This strategy might be considered a good palliative surgical approach.

The Journal of Heart Valve Disease 2012;21:650-654

Triple Valve Repair in Children with Rheumatic Heart Disease: Long-Term Experience

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