Document Detail

Supramitral ring: good prognosis in a subset of patients with congenital mitral stenosis.
MedLine Citation:
PMID:  16488709     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Management of congenital stenotic mitral valvular abnormalities remains an important therapeutic challenge. Supramitral ring constitutes a small but inadequately described subset that has a relatively good outcome with appropriate management. METHODS: Between 1996 and 2004, 15 patients with supramitral ring were managed in this institution. The demographic and clinical features, diagnostic modalities, morphology of the rings, and the surgical management were studied retrospectively. RESULTS: Accurate preoperative diagnosis was possible by transthoracic echocardiography in 11 patients (73%). The associated anomalies were ventricular septal defects in 8 patients (53%) and abnormalities of the left ventricular outflow tract in 7 patients (47%). A circumferential supramitral ring, separate from the mitral valve, was present in 8 patients (53%). In the remaining, the ring was attached circumferentially to the anterior and the posterior mitral leaflets and was most densely adherent at the posteroinferior commissure in 4 of these 7 patients (57%). Complete excision of ring was possible in all cases, without damage to the mitral valve. There was 1 in-hospital death (6%). At a mean follow-up of 30 months, 14 survivors continue to do well, with no significant recurrence of mitral stenosis. CONCLUSIONS: Patients with supramitral ring constitute a subset of patients with congenital mitral stenosis who have a relatively good prognosis. In many cases, the supramitral ring is entirely separate from the mitral valve, and when attached, it is usually most prominent at the posteroinferior commissure. In both cases, complete resection is surgically feasible and usually provides lasting relief.
Sathiakar Paul Collison; Sunil Kumar Kaushal; Kulbushan Singh Dagar; Parvathi Unninayar Iyer; Sumir Girotra; Sitaraman Radhakrishnan; Savitri Shrivastava; Krishna Subramony Iyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  81     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-20     Completed Date:  2006-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  997-1001     Citation Subset:  AIM; IM    
Escorts Heart Institute and Research Centre, New Delhi, India.
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MeSH Terms
Child, Preschool
Heart Defects, Congenital / surgery*,  ultrasonography
Mitral Valve / surgery,  ultrasonography
Mitral Valve Stenosis / congenital,  surgery*,  ultrasonography
Retrospective Studies

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