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Submitral aneurysm in children.

Valdano Manuel1, Miguel Sousa-Uva1,2, Gade Miguel1

  • 1Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.

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|July 5, 2016
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Summary

Submitral aneurysm occurs in children, often presenting as heart failure. Surgical repair, particularly the transatrial approach, is feasible and safe, with good short-term outcomes and potential for mitral valve preservation.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiac Surgery

Background:

  • Submitral aneurysm is a rare cardiac condition.
  • While often diagnosed in adults, it can affect pediatric patients.
  • This study focuses on the surgical management of submitral aneurysm in children.

Purpose of the Study:

  • To describe the surgical experience with submitral aneurysm in pediatric patients.
  • To evaluate the safety and efficacy of different surgical approaches.
  • To assess the short-term outcomes and mitral valve function post-surgery.

Main Methods:

  • A surgical series of eight pediatric patients (<18 years) with submitral aneurysm between March 2011 and December 2015.
  • Surgical correction was performed using transatrial, transatrial-transaneurysmal, or transventricular approaches.
  • Outcomes including mortality, reoperation, mitral regurgitation, and follow-up were analyzed.

Main Results:

  • The cohort included six females with a mean age of 7 years and mean weight of 21.4 kg.
  • Six patients presented in NYHA functional class III or IV, indicating significant heart failure.
  • The transatrial approach was used in most cases; there was one 30-day mortality, and mitral valve replacement was needed in two patients. At follow-up (mean 26.4 months), five patients were alive with no reinterventions required.

Conclusions:

  • Submitral aneurysm is not exclusive to adults and frequently presents as heart failure in children.
  • The transatrial surgical approach is a viable and safe option for pediatric submitral aneurysm.
  • Mitral valve preservation is achievable in most pediatric cases, leading to good short-term results.