Document Detail


Surgical repair of congenital mitral valve malformations in infancy and childhood: a single-center 36-year experience.
MedLine Citation:
PMID:  20554294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Giovanni Stellin; Massimo A Padalino; Vladimiro L Vida; Giovanna Boccuzzo; Emanuele Orrù; Roberta Biffanti; Ornella Milanesi; Alessandro Mazzucco
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Publication Detail:
Type:  Journal Article     Date:  2010-06-15
Journal Detail:
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:
Created Date:  2010-11-16     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1238-44     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Pediatric and Congenital Cardiac Surgery Unit, University of Padua Medical School, Padua, Italy.
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MeSH Terms
Descriptor/Qualifier:
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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