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[Study of the association between aortic coarctation and congenital mitral insufficiency (excluding atrioventricular
Insights
Congenital mitral incompetence combined with coarctation of the aorta worsens prognosis. Surgical outcomes vary, with some patients requiring later mitral valve surgery due to worsening incompetence post-coarctation repair.
Area of Science:
- Cardiology
- Pediatric Surgery
- Congenital Heart Disease
Abstract:
Coarctation of the aorta is accompanied by congenital mitral incompetence in 3% of cases, and this combination worsens the prognosis. A series of 23 cases is reported, and the treatment analysed. In 6 cases only medical treatment was used, either because death was rapid or, on the contrary, satisfactory progress made it possible to wait for the normal age for resection and suture of the coarctation. In one case the severity of the mitral incompetence required early valvular replacement, while the minimal coarctation was ignored. Usually (16 cases) a Crafoord operation is carried out as a first stage, and of the 13 children still alive, 8 had their mitral incompetence improved or stabilised; but in 5 it became worse, requiring mitral valve surgery from 1 to 7 years later. Post mortem study showed the multiplicity of mitral lesions present, and explains the difficulty of mitral 'plasty' operations, which are the best solution in children.