[Acute Mitral Regurgitation in Infant]
1Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.
Insights
Acute mitral regurgitation in infants, often due to chordae tendineae rupture, is increasingly reported. Early diagnosis and mitral valve repair are crucial to prevent infant death from cardiogenic shock.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Neonatal Medicine
Background:
- Acute mitral regurgitation (AMR) in infants was considered rare but is now increasingly recognized.
- Rupture of the chordae tendineae is a primary cause of AMR, particularly noted in Japan.
Observation:
- Infants presenting with sudden cardiorespiratory collapse may have undiagnosed AMR.
- Delayed diagnosis or treatment can lead to severe outcomes, including cardiogenic shock and mortality.
Findings:
- Early diagnosis is critical for managing AMR in infants.
- Mitral valve repair is the preferred treatment for moderate to severe AMR when feasible.
Implications:
- Pediatricians and cardiac specialists must consider AMR in infants with acute cardiorespiratory distress.
- Pediatric cardiac surgeons require specialized skills in mitral valve repair and replacement techniques, including supraannular approaches.
Abstract:
The acute mitral regurgitation of the infants are believed to be very rare until recently. However, there have been increasing number of reports of acute massive mitral regurgitation attributable to rupture of the chordae tendaniae escecially in Japan. If undiagnosed or the optimal treatment including surgery is delayed, it may cause cardiogenic shock and death in infants. Thus pediatricians, pediatric cardiologists and pediatric caridiac surgeons should consider this diagnosis when previously healthy infant suddenly develop cardiorespiratory collapse. It is very important to diagnose early and if there is over moderate mitral regurgitation, the 1st choice will be the mitral valve repair if possible. Pediatric cardiac suregon should be skilled at the mitral valve repair and mitral valve replacement. There are several techniques which are different from the adult operation, so pediatric cardiac surgeon also has to be prepared for these techniques including supraannular mitral valve replacement.
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