Acquired mitral stenosis in children under fifteen

The clinical and hemodynamic studies of acquired MS in 30 children under the age of 15 are reviewed. There are 13 male and 17 female patients with an age range from 9 to 14 (mean 12.6) years. The majority of the patients (78%) are in New York Heart Association functional class 3 or 4. Only 55% of the patients had a history suggestive of previous rheumatic fever. All patients had pulmonary hypertension and 41% had severe pulmonary hypertension. A closed mitral commissurotomy was performed in all patients. There were 3 deaths and 2 patients required reoperation because of restenosis. The early onset of mitral stenosis in our population was suggestive of a very early onset of valvulitis with subsequent fibrosis and narrowing of the mitral valve. This is in contrast to the acute fulminating form of rheumatic fever with valvulitis manifested by severe mitral and or aortic insufficiency.