Objectives: Mitral valve repair (MVr), in pediatric patients with rheumatic heart disease, is now considered to be the optimal solution for severe mitral regurgitation. The rational is that MVr is thought to be as durable as mechanical valve replacement (MVR) and associated with better long-term survival and less long-term morbidity. The objective of the current meta -analysis was to examine the literature for evidence to support this rationale. Method: Google Scholar and PUBMED were searched: January 1st 1966 to May 18th 2024; a meta-analysis was conducted after pragmatically minimising patient and method heterogeneity. Only studies that had a mean/median patient age of 18 years or less were included in the meta-analysis. Results: Two out of ten studies had a mean/median patient age of 18 years or less. These two studies were included in our meta-analysis and represented 486 patients. The Odds ratios, with reference to MVR, for operative mortality and 10-year freedom from re-operation were 2.82 [0.07;248.97] and 1.55 [0.00; 536.36] respectively. The Odds ratios, with reference to MVr for 10-year survival, and 10-year freedom from embolism, bleeding or thrombosis were 1.59 [0.08; 32.19] and 7.5 [0.00; 14878.45] respectively. Conclusions: We found no evidence to suggest that MVr delivers better short-term or long-term outcomes than MVR. There is no evidence to suggest that MVr is less durable than MVR in the long-term.

Keywords: Mitral valve replacement repair paediatric