Cirugía de reparación multivalvular en pacientes congénitos: ¿es posible?

Introduction and objective: Congenital heart valve disease is a wide and heterogeneous spectrum of valvular anomalies with low incidence. We analysed the results and follow-up of all our patients with 2 or more surgical heart valve repairs over a period of 15 years. Methods: We retrospectively analysed all combined valve repairs performed from January 2007 to June 2021 in a tertiary referral hospital. Results: Twenty-five patients were operated with a median age of 4 years: 8 adults with a median age of 54 years, and 17 children with a median age of 13.5 months. Twenty-two patients presented mitral regurgitation, 8 aortic regurgitation, 2 mitral stenosis, and one severe aortic stenosis. Eighteen patients presented tricuspid regurgitation. Sixteen mitro-tricuspid, 7 mitro-aortic, one tricuspid-pulmonary, and one triple mitro-aortic-tricuspid combined heart valve plasties were performed. Three primary plasty failures required reintervention, and one resulted in death. Three patients required a permanent pacemaker in the immediate postoperative course, and one suffered from perioperative myocardial infarction due to right coronary artery kinking secondary to a tricuspid ring suture. Median follow-up was 45.3 months, without late deaths. Two patients were reoperated during follow-up. In the last follow-up echocardiogram, 2 patients had severe mitral regurgitation, one moderate aortic regurgitation, and one severe tricuspid regurgitation, all of them clinically well tolerated. Conclusion: Heart valve plasties of 2 or more valves in patients with congenital heart disease is viable with good short-midterm results. It could be performed as a definitive solution or as palliative treatment in favour of annular growth. (C) 2021 Sociedad Espa n tilde ola de Cirugi acute accent a Cardiovascular y Endovascular. Published by Elsevier Espa n tilde a, S.L.U.