This prospective, multicenter cohort study aims to evaluate the outcomes of surgical repair for pediatric mitral regurgitation (MR) in China. From March 2020 to December 2024, consecutive patients younger than 14 years who underwent mitral valve repair at eight representative congenital heart disease centers were enrolled. Eligible patients were those with at least moderate MR on preoperative echocardiography and no prior mitral valve surgery. Patients with uncorrectable concomitant cardiac anomalies, moderate or greater mitral stenosis, ischemic MR, severe leaflet dysplasia, connective tissue disorders (e.g., Barlow, Marfan), cardiomyopathies, or single-ventricle physiology were excluded. The primary endpoint is a composite of all-cause mortality, reoperation for cardiovascular causes, or recurrence of moderate-or-severe MR during follow-up. Secondary endpoints include perioperative outcomes such as postoperative hospital stay, intensive care unit stay, mechanical ventilation time, and hospitalization cost. This study is designed to provide high-quality prospective evidence on the safety, durability, and predictors of surgical repair for pediatric MR in a contemporary, real-world, multicenter setting. The findings may inform surgical decision-making and postoperative management strategies for this rare but challenging population.
Study Type
OBSERVATIONAL
Enrollment
427
Patients undergoing conventional mitral valve repair, including annuloplasty, leaflet cleft closure, chordal transfer, and chordal resection, et al.
Patients undergoing the standardized mitral valve repair strategy proposed by Professor Li at Fuwai Hospital in 2016, which involves comprehensive exploration and correction of abnormalities at the subvalvular, leaflet, and annular levels.
Pediatric Cardiac Surgery Center, Fuwai Hospital
Beijing, Beijing Municipality, China
Composite Primary Endpoint
Time-to-first event of any of the following: (a) all-cause mortality; (b) mitral valve reoperation; or (c) recurrence of ≥ moderate mitral regurgitation on transthoracic echocardiography.
Time frame: From date of index surgery until last follow-up (up to 5 years)
Postoperative Hospital Length of Stay
Total postoperative days from surgery to hospital discharge.
Time frame: perioperatively
ICU Length of Stay
Consecutive time in intensive care unit.
Time frame: perioperatively
Duration of Invasive Mechanical Ventilation
Cumulative duration of invasive mechanical ventilation during the index hospitalization, including all episodes of intubation and re-intubation.
Time frame: perioperatively
Hospitalization Cost
Total in-hospital medical cost for the index surgical admission (local currency), extracted from billing records.
Time frame: perioperatively
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