Document Detail


Characteristics and management of cleft mitral valve.
MedLine Citation:
PMID:  14662264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to highlight the clinical, morphologic, and pathogenetic features in patients with a cleft mitral valve (MV). BACKGROUND: Few studies have addressed the morphologic features of cleft MV and the outcome of these patients. The pathogenetic features, including the developmental relation to an atrioventricular (AV) septal defect, remain unclear. METHODS: We reviewed the patients with cleft MV that were diagnosed by echocardiography since 1980. Patients with an AV canal, ventriculo-arterial discordance, and hypoplastic ventricles were excluded. RESULTS: Twenty-two patients were identified at a median age of 0.5 years (range 0 to 10.6). In three patients, no chordal attachments of the cleft to the ventricular septum were seen. Ten patients had significant mitral regurgitation (MR), and three had subaortic obstruction by the cleft. Associated cardiac lesions and extracardiac features were present in 13 and 10 patients, respectively. During the median follow-up period of 1.5 years (range 0 to 11.8), two patients died of extracardiac causes, and one neonate died of severe subaortic obstruction. Surgical repair was performed in 10 patients at a median age of 5.2 years (range 1.3 to 10.6). Multivariate analysis showed no predictors for MV surgery. One patient was re-operated for mitral stenosis associated with aortic valve stenosis. Follow-up echocardiography demonstrated moderate MR in two unoperated patients and moderate MV stenosis in two operated patients. CONCLUSIONS: A cleft of the MV comprises a wide spectrum. Important morphologic differences exist with an AV septal defect, although the two lesions may be pathogenetically related. Surgical repair always seems possible. Long-term echocardiographic follow-up is warranted.
Authors:
Alain Fraisse; Tony Abdel Massih; Bernard Kreitmann; Dominique Metras; Pascal Vouhé; Daniel Sidi; Damien Bonnet
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  42     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-09     Completed Date:  2004-01-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1988-93     Citation Subset:  AIM; IM    
Affiliation:
Service de Cardiologie Pédiatrique et de Chirurgie Thoracique et Cardiovasculaire, Hôpital de la Timone, Marseille, France. afraisse@mail.ap-hm.fr
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Echocardiography
Follow-Up Studies
Heart Defects, Congenital
Humans
Infant
Infant, Newborn
Mitral Valve / abnormalities*,  pathology,  surgery,  ultrasonography
Mitral Valve Insufficiency / etiology
Pulmonary Subvalvular Stenosis / etiology
Treatment Outcome

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