• Wolfram Beierlein, Vera Becker, Robert Yates, Victor Tsang, Martin Elliott, Marc de Leval, and Carin van Doorn.
• Cardiothoracic Unit, Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom.
• Eur J Cardiothorac Surg. 2007 May 1; 31 (5): 860-5.

ObjectiveIn children, mechanical mitral valve replacement may be the only option if the failing mitral valve cannot be repaired. Mandatory anticoagulation and the fixed size prosthesis are of concern in the growing child, but long-term follow-up results are lacking.MethodsSingle centre, extended retrospective study of 54 patients who underwent first mitral valve replacement between June 1982 and December 1997. Median age at operation was 3.0 years (range 2 days-18.1 years), 21 patients were15 years (maximum 22 years) in nine patients.ResultsThirty-day mortality was 42% in patientsConclusionsAt 10 years follow-up after mechanical mitral valve replacement, most children had suffered an adverse event. At 15 years, all children with a prosthesis<23 mm had outgrown their valve, but redo-mitral valve replacement with a larger size prosthesis was always possible, and carried low operative risk. Long-term anticoagulation was well tolerated. In children every effort should be made to preserve the native valve.

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