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Mitral Valve Repair in a 2 year old
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Mitral Valve Repair in a 2 year old

My 2 year old daughter has moderate to severe mitral insufficiency due to an anterior leaflet prolapse.  Her left atrium and left ventricle have increased in size significantly in the last 3 months.  She is starting to show signs of excessive sweating and difficulty breathing upon exercise.  We are expecting that she will need surgery to repair her mitral valve soon.  Our in-state surgeon does not feel confident that he can successfully repair her valve due to his lack of experience with anterior leaflet repairs.  He has advised us to seek a surgeon that has more experience and a higher success rate in this type of congenital defect.   He has suggested 2 surgeons, but I want to feel confident that we are in fact choosing the best surgeon for our daughter.

Q:  How can I research and find surgeons with the most experience and the highest success rate in repairing an anterior leaflet prolapse in a 2 year old?   We are willing to go to any location to have the best chance of a valve repair and not a valve replacement.  

Q:  Is a minimally-invasive approach feasible for a mitral valve repair in a 2 year old who weighs 27 pounds?  How can I find which, if any, surgeons have had success using this approach in toddlers, without visiting them individually?  I have spoken with one well-respected surgeon who said that he would not attempt the minimally-invasive approach in a young child.

Thank you!
Teri - Lexie's Mom
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Teri,

Thanks for the post.

Q: How can I research and find surgeons with the most experience and the highest success rate in repairing an anterior leaflet prolapse in a 2 year old? We are willing to go to any location to have the best chance of a valve repair and not a valve replacement.

This question required some work.  There is no database to provide this info.  It is pretty rare for a 2-yo to have isolated prolapse (usually it is from endocaridal cushiion defect, neonatal Marfan's, cleft valve, etc).  The other possibly associated conditions will influence which surgeon may be the best.

Some of the best centers are here at CCF (Dr Roger Mees), Boston Children's, and Stanford.  Other places also with great surgeons include CHOP and Baylor.

Q: Is a minimally-invasive approach feasible for a mitral valve repair in a 2 year old who weighs 27 pounds? How can I find which, if any, surgeons have had success using this approach in toddlers, without visiting them individually? I have spoken with one well-respected surgeon who said that he would not attempt the minimally-invasive approach in a young child.

I do not know the answer to this question.  If you would like to email me, I'll be able to direct you to one of the best pediatric cardiologists I know, who should be able to help.

Best of luck.

***@****
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