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Balloon mitral valvotomy in youngest documented rheumatic mitral stenosis patient

Achyut Sarkar1, Shailesh Patil1, Imran Ahmed1

  • 1Department of Pediatric Cardiology, IPGMER, Kolkata, India.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|May 28, 2015
PubMed

Insights

Juvenile rheumatic mitral stenosis (MS) is a significant concern in children. This report details a successful percutaneous mitral commissurotomy (PTMC) in a 4-year-old, highlighting PTMC

Area of Science:

  • Pediatric Cardiology
  • Rheumatic Heart Disease
  • Interventional Cardiology

Background:

  • Juvenile rheumatic mitral stenosis (MS) is prevalent in the Indian subcontinent, necessitating early intervention.
  • Severe MS in very young children (<5 years) poses significant risks of rapid hemodynamic compromise and mortality.
  • Management decisions are complex, influenced by valve condition and parental preferences.

Observation:

  • A 4-year-old child presented with severe rheumatic MS, diagnosed at 2.5 years, experiencing recurrent pulmonary edema.
  • The child underwent a successful balloon mitral valvotomy, a form of percutaneous transmitral commissurotomy (PTMC).

Findings:

  • This case represents one of the youngest documented instances of severe rheumatic heart disease and successful PTMC in a preschool-aged child.
  • The procedure was technically challenging but ultimately life-saving, demonstrating the potential of PTMC in this age group.

Implications:

  • Percutaneous mitral commissurotomy (PTMC) can be a crucial, life-saving intervention for severe childhood MS, even in very young patients.
  • Further consensus is needed to address the technical challenges associated with PTMC in this pediatric population.
  • This case underscores the importance of early recognition and advanced interventional options for juvenile rheumatic heart disease.

Keywords:
early managementjuvenilepreschooltechnical issues

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