Quality of Life after Mitral Valve Replacement or Repair in Children: A Comparative Study at the Cuomo Pediatric Cardiology Center

Abstract

This retrospective–prospective cohort study conducted between January 2017 and January 2019 included 60 children who underwent surgery for mitral valve disease at the Cuomo Pediatric Cardiology Center in Dakar, Senegal. The objective was to evaluate clinical and paraclinical outcomes, as well as quality of life (QoL), before and after mitral valve replacement (MVR) or mitral valve repair (MVr). Quality of life was assessed using an adapted and abbreviated version of the SF-36 questionnaire. Significant postoperative improvement in QoL was observed in both groups. Mean global scores increased from 42.35 to 73.73 after MVR and from 40.19 to 72.61 after MVr, with no statistically significant difference between techniques. Improvements were noted across multiple domains, including vitality, physical autonomy, emotional status, social functioning, pain, and perceived future health. Dyspnea improved more markedly in the MVr group, whereas no significant change was observed in the MVR group for this dimension. Most patients (66.7%) experienced uncomplicated postoperative outcomes. Postoperative echocardiography demonstrated satisfactory functional recovery, with a mean left ventricular ejection fraction of 66.2% in the MVr group and 62.7% in the MVR group. In conclusion, both mitral valve repair and replacement significantly improved quality of life in this pediatric cohort, with comparable medium-term outcomes. Surgical strategy should be individualized according to anatomical characteristics and clinical context.