Related Experiment Videos
[Mitral valve disease in infants. Anatomical and functional evaluation by echocardiography]
1Hospital Regional Guillermo Grant Benavente, Concepción.
Insights
Congenital mitral valve abnormalities affect infants under 24 months, with papillary muscle deformities causing stenosis and annulus dilation causing insufficiency. Echocardiography aids in diagnosing these conditions and guiding management.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Congenital mitral valve abnormalities are a significant cause of morbidity in infants.
- Accurate diagnosis and characterization are crucial for effective management.
Purpose of the Study:
- To determine the incidence and characteristics of mitral valve abnormalities in infants aged 0-24 months.
- To identify associated cardiac defects and understand the mechanisms of stenosis and insufficiency.
Main Methods:
- Analysis of records from 3,583 infants undergoing echocardiography for suspected heart disease.
- Utilized bi-dimensional ultrasound and pulsed Doppler studies.
- Corroborated findings with clinical examination, cardiac catheterization, surgery, and necropsy data.
Main Results:
- Mitral valve abnormalities were detected in 88 infants (2.46%).
- Congenital mitral stenosis was primarily caused by papillary muscle deformities (100%), while mitral insufficiency was often due to annulus dilation (49%).
- Common associated defects included ventricular septal defects (43%), aortic stenosis (27%), and coarctation of the aorta (26%).
Conclusions:
- Echocardiography provides valuable, non-invasive data on mitral valve architecture and function in infants.
- Doppler parameters correlate with the severity of mitral valve abnormalities.
- Findings guide the diagnosis and management of congenital mitral valve disease in pediatric patients.
Abstract:
To describe the incidence of mitral valve abnormalities among infants aged 0 to 24 months, their anatomic features, site of lesion, severity and associated heart defects, the records of 3,583 such patients submitted for bi-dimensional ultrasound and pulsed Doppler cardiac studies by presumptive heart disease were analyzed. Mitral valve abnormalities were thus detected in 88 of these cases, and were also documented by clinical examination (n: 88), heart catheterization and angiocardiography (n: 11), surgery (n: 17) and necropsy (n: 2). Seventy five cases had additional heart disease, most commonly aortic stenosis (27%), aortic coarctaction (26%) and ventricular septal defects (43%). Papillary muscle deformities at the subvalvar mitral apparatus were considered to be the most frequent mechanism for congenital mitral stenosis (100%), and annulus dilatation was the most frequent cause of mitral insufficiency (49%). Relative incidences of mitral valve stenosis and insufficiency among the whole studied sample were 0.5% and 1.48% respectively. There was a rough correlation between Doppler transmital gradient or regurgitation jet area and the corresponding mitral valve abnormality. This kind of noninvasively obtained data about mitral architecture and function seems to be a very useful and sensitive guide to define and manage this patients.