| Surgical repair of congenital mitral valve malformations in infancy and childhood: a single-center 36-year experience. | |
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MedLine Citation:
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PMID: 20554294 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We sought to evaluate the results of surgical repair and determine predictors for the late outcome of congenital mitral valve dysplasia. METHODS: Preoperative, operative and postoperative data were obtained from an institutional database; follow-up data came from regular clinical evaluation at our institution or elsewhere. Patients were divided into isolated and complex cases according to the complexity of associated lesions. RESULTS: Between 1972 and 2008, 93 patients (43 male and 50 female patients) underwent mitral repair (median, 4.5 years; range, 0.16-19.8 years). Predominant mitral regurgitation was present in 52%. Associated cardiac anomalies were present in 72%. Sixty-one patients were in the complex group. All patients underwent successful mitral repair. Surgical repair was tailored to the patient's valve anatomy. Early death was 7.5%. The postoperative course was uneventful in 86% of patients. At a mean follow-up of 10.3 years (median, 8.4 years; completeness, 94%), late mortality is 8% (7 patients). Twelve patients underwent mitral reintervention (11 replacements and 1 repair). Among the 80 survivors, 82.5% were in New York Heart Association class I or II, and 61.2% had some degree of persistent mitral regurgitation or stenosis, despite stable hemodynamics. Stenosis is a statistically significant risk factor for surgical intervention at less than 1 year of age and is related to higher overall mortality and incidence of late cardiac failure and mitral dysfunction; parachute mitral valve is related to higher mortality and morbidity. CONCLUSIONS: Mitral valve repair shows acceptable early mortality and reoperation rates. Mitral malformations in the complex group are related to a significantly higher risk of reoperation on the mitral valve. Parachute mitral valve is associated with a higher rate of early mortality. |
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Authors:
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Giovanni Stellin; Massimo A Padalino; Vladimiro L Vida; Giovanna Boccuzzo; Emanuele Orrù; Roberta Biffanti; Ornella Milanesi; Alessandro Mazzucco |
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Publication Detail:
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Type: Journal Article Date: 2010-06-15 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 140 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-16 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1238-44 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Pediatric and Congenital Cardiac Surgery Unit, University of Padua Medical School, Padua, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Female Humans Infant Infant, Newborn Logistic Models Male Mitral Valve / abnormalities* Mitral Valve Insufficiency / congenital, surgery* Mitral Valve Stenosis / congenital, surgery* Outcome and Process Assessment (Health Care)* Risk Factors Survival Rate Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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