Mitral valve (MV) repair is an attractive therapy in children owing to the poor survival of reported pediatric MV replacement series. From 1980 to 1992, 71 patients (pts) underwent MV repair for mitral regurgitation (MR). Mean age was 8.7 (range, 0.24 to 15 ) years. The cause of the mitral disease was rheumatic in 56 pts (79 %) and congenital in 15 pts (21 %).Twenty four pts (33%) had other cadiac lesions and underwent associated procedures: aortic valve replacement (7 pts), tricuspid annuloplasty (6 pts), VSD closure (3pts) and miscellaneous (7 pst). The techniques included prosthetic ring annuloplasty (56 pts), chordae shortening ( 44 pts), leaflet resection (17 pts), chordae transposition (7 pts), papillary muscle fenestration (3pts), commisuroplasty (3 pts). There were 3 (4 %) hospital deaths. Seven pts (10 %) required early reoperation for residual MR. Mean follow-up was 28 months ( range, 1 to 120 ). Three (4% ) late deaths (only one MV repair related ) occured. One year and five year actuarial survival were consecutively 91±4 % and 85±7 % without any significative difference between the rheumatic and congenital gruop. There were no tromboembolic event. Four pts (6% ) underwent reoperation for late MV repair failure. 56 of 58 pts (97 ) with repaired MV were in NYHA functional class I or II.

Despite the high rate of early failure, MV repair appears to be an effective and safe procedure in children.