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Effects of rheumatic mitral valvular disease and mitral valve replacement on growth and development
Insights
Rheumatic mitral valvular disease and surgery impact children's growth. Mitral valve replacement improved growth rates but did not fully restore normal stature or body weight in Southern Chinese children.
Area of Science:
- Pediatric Cardiology
- Developmental Biology
- Rheumatic Heart Disease
Background:
- Rheumatic mitral valvular disease (RMVD) can significantly impair growth and development in children.
- Understanding the long-term effects of RMVD and surgical intervention is crucial for pediatric patient management.
Purpose of the Study:
- To investigate the impact of RMVD and subsequent mitral valve replacement (MVR) on the growth and development of Southern Chinese children.
- To assess the effects of MVR on physical stature, body weight, skeletal maturity, and cortical bone growth.
Main Methods:
- A cohort of 37 Southern Chinese children with RMVD underwent MVR.
- Stature and body weight were measured pre- and post-operatively.
- Skeletal maturity and cortical bone growth were assessed post-operatively, with a subset assessed pre-operatively.
Main Results:
- Patients exhibited retarded stature and body weight at the time of surgery.
- MVR led to increased growth rates in stature and body weight, but not catch-up growth to normal dimensions.
- Skeletally immature patients showed retarded bone ages and impaired cortical bone growth; skeletally mature patients also showed reduced cortical bone.
Conclusions:
- Mitral valve replacement partially alleviates the adverse effects of rheumatic mitral valvular disease on children's growth and development.
- While surgery improves growth trajectories, long-term monitoring for complete catch-up growth is warranted.
- The findings highlight the complex interplay between rheumatic heart disease, surgical intervention, and pediatric skeletal and somatic development.
Abstract:
The effects of rheumatic mitral valvular disease and mitral valve replacement on the growth and development of 37 Southern Chinese children were studied. The stature and body weight were measured before and after operation. All the patients had their skeletal maturity and cortical bone growth assessed after operation, but only 10 patients were similarly assessed before operation. At the time of operation the stature and body weight of all patients were generally retarded. The surgery which corrected the haemodynamic abnormality resulted in increases in the growth rates in stature and body weight but there was no evidence of a catch-up growth with subsequent return to normal dimensions. The patients who are skeletally immature had retarded bone ages and impaired growth of cortical bone. The general trend, though less marked, also showed a reduction in cortical bone in the skeletally mature patients. Surgery appears, at least partially, to alleviate the adverse effects of the disease on the growth and development of patients.