| Results of mitral valve reconstruction in children with rheumatic heart disease. | |
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MedLine Citation:
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PMID: 7574945 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Between January 1988 and November 1994, we developed techniques of reconstructing diseased mitral valves in patients with rheumatic heart disease. Four hundred thirteen patients underwent mitral valve repair using these techniques. Of these, 125 children and adolescents less than 15 years of age form the study group. METHODS: The mean age was 8.9 +/- 4.3 years (range, 5 to 15 years). One hundred seventeen patients (93.6%) had rheumatic heart disease. There were 72 boys (57.6%) and 53 girls (42.4%). All of these patients were symptomatic: New York Heart Association class III or IV. Mitral regurgitation alone was present in 49 patients (39.2%), and combined mitral stenosis and regurgitation were present in 76 patients (60.8%). Surgical techniques included commissurotomy (n = 70; 56%), annuloplasty (n = 122; 97.6%), chordal shortening (n = 46; 36.8%), cusp thinning (n = 27; 5.6%), and associated procedures for tricuspid valve disease (6 patients) and aortic valve disease (2 patients). RESULTS: The operative mortality rate was 4.8% (6 patients), and late deaths occurred in 1.6% (2 patients). Follow-up was 378.25 patient-years. In 15 patients, severe mitral regurgitation developed after a mean follow-up of 37.14 +/- 20.47 months (seven reoperations). At 6 years, actuarial and event-free survival rates were 92.1% +/- 3.19% and 75% +/- 8.18%, respectively. One patient (0.15%/patient-year) had transient right hemiparesis. None had anticoagulation-related bleeding. CONCLUSION: Mitral valve reconstruction in children and adolescents with rheumatic mitral regurgitation provides satisfactory early results. Progression of disease is the most important risk factor for reoperation. The technique described provided stable repair in the majority of patients. |
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Authors:
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A S Kumar; P N Rao; A Saxena |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 60 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1995 Oct |
Date Detail:
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Created Date: 1995-11-08 Completed Date: 1995-11-08 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1044-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Female Heart Valve Diseases / surgery Humans Male Mitral Valve / surgery* Mitral Valve Insufficiency / surgery Reoperation Rheumatic Heart Disease / surgery* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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