CONGENITAL-MALFORMATIONS OF MITRAL-VALVE IN CHILDREN - PATHOLOGY AND SURGICAL TREATMENT

  • 1 January 1976
    • journal article
    • research article
    • Vol. 72  (6) , 854-866
Abstract
A systematic study of congenital mitral valve malformations was undertaken on a surgical basis in an attempt to develop techniques of valvular reconstruction adapted to the various lesions. Children [47] between the ages of 4 mo. and 12 yr (average 6 yr, 4 mo.) were operated on between Jan. 1970-March 1976. Valvular lesions were classified into 4 groups: Group 1, mitral insufficiency owing to valvular lesions; Group 2, mitral insufficiency with subvalvular lesions; Group 3, mitral insufficiency and stenosis; Group 4, stenosis. Associated lesions (ventricular or atrial septal defects, coarctation or aortic valve stenosis) were present in 31 patients (65%) and were corrected during the same operation. Valve reconstruction was possible in 38 patients; valve replacement was necessary in 9 patients. In the valve repair group there were 3 operative deaths (8%), no late deaths, 1 reoperation for residual ventricular septal defect and 1 myocardial infarction. In the valve replacement group of 9 patients, there were 3 operative deaths, 3 late deaths and 1 case of repeated embolization. Of 38 patients, 31 in the valve repair group were classified into Functional Class 1 after the operation (86%), 2 were in Class 2 and 1 in Class 3. Minimal or moderate regurgitation and cardiomegaly persisted in the majority of the patients. Pulmonary artery pressure significantly decreased as demonstrated by postoperative catheterization in 17 patients.

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