Document Detail

Isolated congenital mitral valve regurgitation presenting in the first year of life.
MedLine Citation:
PMID:  20345374     Owner:  NLM     Status:  MEDLINE    
AIM: Isolated congenital mitral regurgitation is rare and, when presenting in infancy, reflects severity of the malformation. The natural history is often fatal, and management during the first year of life remains a therapeutic challenge. These infants are poorly understood largely because of an absence of reporting in the medical literature and limited experience in each institution. We reviewed our own experience in order to add to the understanding of this condition. METHODS: A retrospective review was performed on seven infants with significant isolated congenital mitral regurgitation. An associated patent ductus arteriosus was present in two. Mean age at referral was 17.7 weeks (1 day to 47 weeks) and mean weight was 6.8 kg (3.7-12.5 kg). RESULTS: Two infants were managed conservatively, and one underwent surgical ligation of a patent ductus arteriosus. Following spontaneous and surgical duct closure, no further intervention was required in two infants. The remaining four infants underwent three valve repairs and three valve replacements. The in-hospital mortality was 29%, occurring in those under 1 year of age undergoing emergency valve surgery. Two reoperations followed mitral valve repair in the first year of life. No significant complications or late deaths occurred. CONCLUSIONS: Our experience suggests closure of a patent ductus arteriosus should be undertaken prior to mitral valve surgery. There may be a poorer prognosis in those under one year of age requiring emergency mitral valve surgery. Those who can be managed conservatively or undergo mitral valve surgery as an elective procedure tend to have a better outcome.
Anusha Ganeshalingham; Kirsten Finucane; Tim Hornung
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Publication Detail:
Type:  Journal Article     Date:  2010-03-25
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  46     ISSN:  1440-1754     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  159-65     Citation Subset:  IM    
Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand.
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MeSH Terms
Ductus Arteriosus, Patent / surgery
Heart Failure / etiology,  surgery
Hospital Mortality
Infant, Newborn
Mitral Valve / surgery*
Mitral Valve Insufficiency / complications,  congenital*,  mortality,  surgery*
Retrospective Studies

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