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Mitral valve surgery in children.

B R Kalke1, J M Desai, R Magotra

  • 1Department of Cardiovascular and Thoracic Surgery, T. N. Medical College, Bombay, India.

The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1989
PubMed
Summary
This summary is machine-generated.

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Surgical interventions for rheumatic mitral valve disease in pediatric patients yielded positive outcomes, with most achieving excellent results and normal growth post-operation. Long-term follow-up showed sustained benefits, though restenosis and embolization were noted complications.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Rheumatic Heart Disease

Background:

  • Rheumatic mitral valve disease significantly impacts pediatric patients, often requiring surgical intervention.
  • Patients aged 15 or younger with severe mitral stenosis or regurgitation present unique surgical challenges.

Purpose of the Study:

  • To evaluate the long-term outcomes of surgical treatments for rheumatic mitral stenosis and regurgitation in pediatric patients.
  • To assess the efficacy and safety of closed mitral commissurotomy and valve replacement/reconstruction in this population.

Main Methods:

  • Retrospective analysis of 113 pediatric patients (5-15 years) operated on between 1968 and 1985 for rheumatic mitral valve disease.
  • Seventy-two patients underwent closed mitral commissurotomy for stenosis; 40 patients had valve replacement or reconstruction for regurgitation.

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Main Results:

  • Closed mitral commissurotomy resulted in 2.7% mortality, with 83.5% excellent outcomes, but 23.0% experienced restenosis over 15 years.
  • Mitral valve replacement/reconstruction had a 10.0% mortality, with 80.0% excellent outcomes; three patients had minor embolization.
  • All survivors achieved independence in daily living and normal growth patterns.

Conclusions:

  • Surgical management of rheumatic mitral valve disease in children can lead to excellent functional recovery and normal growth.
  • While effective, long-term surveillance is crucial due to risks of restenosis and embolic events, particularly after commissurotomy.