Mitral valve surgery in children involves correcting congenital and acquired pathologies, with a reported mortality rate of 0.9%. Low cardiac output syndrome (LCOS) is a serious complication with the incidence of 20–25%. The aim of the study was to estimate possible prognostic factors of LCOS in children undergoing mitral valve procedure. This single-center retrospective analysis enrolled children aged <18 years who underwent mitral valve surgery during 24 year period. Preoperative clinical and laboratory parameters, and operative factors were analyzed. Thirty consecutive pediatric patients (11 (37%) males and 19 (63%) females) in median (Q – Q) age of 57 (25–115) months, who underwent mitral valve replacement, were included. The 30-day mortality was 7% (2 patients) and was related to postoperative multiorgan failure. LCOS occurred in 8 (27%) children. The receiver operator curve (ROC) analysis established parameters that have predictive value for LCOS occurrence: cardiopulmonary bypass (CPB) time, with 89 ​min as optimal cut-off point (AUC ​= ​0.744, p ​= ​0.011) yielding sensitivity of 100% and specificity of 42.9%; left ventricular ejection fraction (LVEF) ​< ​60 % (AUC ​= ​0.824, okp ​= ​0.001) with sensitivity of 62.5% and specificity of 93.75%; and red blood cell distribution width (RDW) above 14.5 % (AUC ​= ​0.840, p ​< ​0.001; sensitivity of 87.5% and specificity of 75%). In mitral valve replacement in pediatric patients, CPBtime above 89 ​min, preoperative LVEF below 60% and preoperative RDW above 14.5% can be regarded as the potential predictors of LCOS.

中文翻译：

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红细胞大小不均可能是接受二尖瓣手术的儿童低心输出量综合征的预测因素

儿童二尖瓣手术涉及纠正先天性和后天性病变，据报道死亡率为 0.9%。低心输出量综合征（LCOS）是一种严重的并发症，发生率为 20-25%。该研究的目的是评估接受二尖瓣手术的儿童 LCOS 可能的预后因素。这项单中心回顾性分析纳入了 24 年内接受二尖瓣手术的 18 岁以下儿童。分析术前临床和实验室参数以及手术因素。纳入了 30 名连续接受二尖瓣置换术的儿科患者（11 名（37%）男性和 19 名（63%）女性），中位（Q-Q）年龄为 57（25-115）个月。 30 天死亡率为 7%（2 名患者），与术后多器官衰竭有关。 8 名 (27%) 儿童发生 LCOS。受试者工作曲线 (ROC) 分析建立了对 LCOS 发生具有预测价值的参数：体外循环 (CPB) 时间，以 89 分钟为最佳截止点（AUC = 0.744，p = 0.011）产生灵敏度100%，特异性为 42.9%；左心室射血分数 (LVEF) < 60 %（AUC = 0.824，okp = 0.001），敏感性为 62.5%，特异性为 93.75%；红细胞分布宽度 (RDW) 高于 14.5%（AUC = 0.840，p < 0.001；敏感性为 87.5%，特异性为 75%）。在儿科患者二尖瓣置换术中，CPB时间超过89分钟、术前LVEF低于60%和术前RDW高于14.5%可被视为LCOS的潜在预测因素。