Skip to main content

Congenital Mitral Valve Anomalies

  • Chapter
  • First Online:
Congenital Heart Disease in Pediatric and Adult Patients

Abstract

Congenital anomalies of the mitral valve represent a broad spectrum of lesions that are often associated with other congenital heart anomalies. The reported incidence of congenital anomalies of the mitral valve in an echocardiographic study of 13,400 subjects was 0.5 % (Banerjee et al. 1995). These lesions affect valve function in a variable manner. When indicated, surgical intervention results in good long-term results (Hoashi et al. 2010; Lee et al. 2010; Serraf et al. 2000). In the last few years, enhanced knowledge of the functional as well as anatomical aspects of these lesions accompanied by concomitant significant advances in the diagnosis as well as anesthetic and surgical management has contributed to improved outcomes. This chapter provides an overview of the different congenital malformations that can affect the mitral valve excluding mitral valve anomalies in atrioventricular septal defects (AVSD) and univentricular hearts and focuses on the anesthetic and surgical management of these congenital mitral anomalies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aharon AS, Laks H, Drinkwater DC, et al. Early and late results of mitral valve repair in children. J Thorac Cardiovasc Surg. 1994;107:1262–70.

    CAS  PubMed  Google Scholar 

  • Asante-Korang A, O'Leary PW, Anderson RH. Anatomy and echocardiography of the normal and abnormal mitral valve. Cardiol Young. 2006;16 (Suppl 3):27–34.

    Google Scholar 

  • Azakie A, Russell J, McCrindle BW, Arsdell G, Benson L, Coles J, et al. Anatomic repair of anomalous left coronary artery from the pulmonary artery by aortic reimplantation: early survival, patterns of ventricular recovery and late outcome. Ann Thorac Surg. 2003;75:1535–41.

    Article  PubMed  Google Scholar 

  • Banerjee A, Kohl T, Silverman NH. Echocardiographic evaluation of congenital mitral valve anomalies in children. Am J Cardiol. 1995;76:1284–91.

    Article  CAS  PubMed  Google Scholar 

  • Calafiore AM, Gallina S, Iaco AL, et al. Mitral valve surgery for functional mitral regurgitation: should moderate-or-more tricuspid regurgitation be treated? A propensity score analysis. Ann Thorac Surg. 2009;87:698–703.

    Article  PubMed  Google Scholar 

  • Caldarone CA, Raghuveer G, Hills CB, et al. Long-term survival after mitral valve replacement in children aged <5 years: a multi-institutional study. Circulation. 2001;104(12 Suppl 1):143–7.

    Article  Google Scholar 

  • Carpentier A, Brizard CP. Congenital malformations of the mitral valve. In: Stark J, de Leval M, Tsang V, editors. Surgery for congenital heart defects. London: Wiley; 2006. p. 573–90.

    Chapter  Google Scholar 

  • Carpentier A, Branchini B, Cour JC, Asfaou E, Villani M, Deloche A, et al. Congenital malformations of the mitral valve in children. Pathology and surgical treatment. J Thorac Cardiovasc Surg. 1976;72:854–66.

    CAS  PubMed  Google Scholar 

  • Chauvaud SM, Milhailenau SA, Gaer JAR, Carpentie AC. Surgical treatment of mitral valvar stenosis: “The Hospital Broussais” experience. Cardiol Young. 1997;7:5–14.

    Google Scholar 

  • Chauvaud S, Fuzellier JF, Houel R, Berrebi A, Mihaileanu S, Carpentier A. Reconstructive surgery in congenital mitral valve insufficiency (Carpentier’s techniques): long-term results. J Thorac Cardiovasc Surg. 1998;115:84–92.

    Article  CAS  PubMed  Google Scholar 

  • Collins-Nakai RL, Rosenthal A, Castaneda AR, Bernhard WF, Nadas AS. Congenital mitral stenosis. A review of 20 years’ experience. Circulation. 1977;56:1039–47.

    Article  CAS  PubMed  Google Scholar 

  • Davachi F, Moller JH, Edwards JE. Diseases of the mitral valve in infancy. An anatomic analysis of 55 cases. Circulation. 1971;43:565–79.

    Article  CAS  PubMed  Google Scholar 

  • Ender J, Selbach M, Borger MA, et al. Endocardiographic identification of iatrogenic injury of the circumflex coronary artery during minimally invasive mitral valve repair. Ann Thorac Surg. 2010;89:1866–72.

    Article  PubMed  Google Scholar 

  • Günther T, Mazzitelli D, Schreiber C, et al. Mitral-valve replacement in children under 6 years of age. Eur J Cardiothorac Surg. 2000;17:426–30.

    Article  PubMed  Google Scholar 

  • Hoashi T, Bove EL, Devaney EJ, et al. Mitral valve repair for congenital mitral valve stenosis in the pediatric population. Ann Thorac Surg. 2010;90:36–41.

    Article  PubMed  Google Scholar 

  • Kadoba K, Jonas RA, Mayer JE, Castaneda AR. Mitral valve replacement in the first year of life. J Thorac Cardiovasc Surg. 1990;100:762–8.

    CAS  PubMed  Google Scholar 

  • Kanani M, Moorman AF, Cook AC, et al. Development of the atrioventricular valves: clinicomorphological correlations. Ann Thorac Surg. 2005;79:1797–804.

    Article  PubMed  Google Scholar 

  • Kirklin KW, Barrat-Boyes BS. Anatomy, dimension and terminology. In: Kirklin KW, Barrat-Boyes BS, editors. Cardiac surgery. 2nd ed. London: Churchill Livingstone; 1993. p. 3–60.

    Google Scholar 

  • Kojori F, Chen R, Caldarone CA, et al. Outcomes of mitral valve replacement in children: a competing-risks analysis. J Thorac Cardiovasc Surg. 2004;128:703–9.

    Article  PubMed  Google Scholar 

  • Krishnan US, Gersony WM, Berman-Rosenzweig E, Apfel HD. Late left ventricular function after surgery for children with chronic symptomatic mitral regurgitation. Circulation. 1997;96:4280–5.

    Article  CAS  PubMed  Google Scholar 

  • Kruithof BP, Krawitz SA, Gaussin V. Atrioventricular valve development during late embryonic and postnatal stages involves condensation and extracellular matrix remodeling. Dev Biol. 2007;302:208–17.

    Article  CAS  PubMed  Google Scholar 

  • Kutty S, Colen TM, Smallhorn JF. Three-dimensional echocardiography in the assessment of congenital mitral valve disease. J Am Soc Echocardiogr. 2014;27:142–54.

    Article  PubMed  Google Scholar 

  • Layman TE, Edwards JE. Anomalous mitral arcade. A type of congenital mitral insufficiency. Circulation. 1967;35:389–95.

    Article  CAS  PubMed  Google Scholar 

  • Lechner E, Hofer A, Leitner-Peneder G, et al. Levosimendan versus milrinone in neonates and infants after corrective open-heart surgery: a pilot study. Pediatr Crit Care Med. 2012;13:542–8.

    Article  PubMed  Google Scholar 

  • Lee C, Lee CH, Kwak JG, et al. Long-term results after mitral valve repair in children. Eur J Cardiothorac Surg. 2010;37:267–72.

    PubMed  Google Scholar 

  • Little SH, Pirat B, Kumar R, et al. Three-dimensional color doppler echocardiography for direct measurement of vena contracta area in mitral regurgitation: in vitro validation and clinical experience. JACC Cardiovasc Imaging. 2008;1:695–704.

    Article  PubMed  PubMed Central  Google Scholar 

  • McCarthy JF, Neligan MC, Wood AE. Ten years’ experience of an aggressive reparative approach to congenital mitral valve anomalies. Eur J Cardiothorac Surg. 1996;10:534–9.

    Article  CAS  PubMed  Google Scholar 

  • Mitruka SN, Lamberti JJ. Congenital heart surgery nomenclature and database project: Mitral valve disease. Ann Thorac Surg. 2000;69(4 Suppl):S132–46.

    Article  CAS  PubMed  Google Scholar 

  • Moore P, Adatia I, Spevak PJ, Keane JF, Perry SB, Castaneda AR, et al. Severe congenital mitral stenosis in infants. Circulation. 1994;89:2099–106.

    Article  CAS  PubMed  Google Scholar 

  • Moran AM, Daebritz S, Keane JF, Mayer JE. Surgical management of mitral regurgitation after repair of endocardial cushion defects: early and midterm results. Circulation. 2000;102(19 Suppl 3):III160–5.

    CAS  PubMed  Google Scholar 

  • Morray JP, Lynn AM, Hendon PS, et al. Hemodynamic effects of ketamine in children with congenital heart disease. Anesth Analg. 1984;895–9.

    Google Scholar 

  • Murakami T, Nakazawa M, Nakanishi T, Momma K. Prediction of postoperative left ventricular pump function in congenital mitral regurgitation. Pediatr Cardiol. 1999;20:418–21.

    Article  CAS  PubMed  Google Scholar 

  • Ohlsson A, Shah PS. Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low-birth-weight infants. Cochrane Database Syst Rev. 2015;(3):CD010061.

    Google Scholar 

  • Oosthoek PW, Wenink AC, Macedo AJ, Gittenberger-de Groot AC. The parachute-like asymmetric mitral valve and its two papillary muscles. J Thorac Cardiovasc Surg. 1997;114:9–15.

    Article  CAS  PubMed  Google Scholar 

  • Oosthoek PW, Wenink AC, Wisse LJ, et al. Development of the papillary muscles of the mitral valve: morphogenetic background of parachute-like asymmetric mitral valves and other mitral valve anomalies. J Thorac Cardiovasc Surg. 1998;116:36–46.

    Article  CAS  PubMed  Google Scholar 

  • Oppido G, Davies B, McMullan DM, Cochrane AD, Cheung MM, d'Udekem Y, et al. Surgical treatment of congenital mitral valve disease: Midterm results of a repair-oriented policy. J Thorac Cardiovasc Surg. 2008;135:1313–20.

    Article  PubMed  Google Scholar 

  • Prifti E, Vanini V, Bonacchi M, Frati G, Bernabei M, Giunti G, et al. Repair of congenital malformations of the mitral valve: early and midterm results. Ann Thorac Surg. 2002;73:614–21.

    Article  PubMed  Google Scholar 

  • Raghuveer G, Caldarone CA, Hills CB, Atkins DL, Belmont JM, Moller JH. Predictors of prosthesis survival, growth, and functional status following mechanical mitral valve replacement in children aged <5 years, a multi-institutional study. Circulation. 2003;108 Suppl 1:II174–9.

    PubMed  Google Scholar 

  • Rosenquist GC. Congenital mitral valve disease associated with coarctation of the aorta: a spectrum that includes parachute deformity of the mitral valve. Circulation. 1974;49:985–93.

    Article  CAS  PubMed  Google Scholar 

  • Ruckman RN, van Praagh R. Anatomic types of congenital mitral stenosis: report of 49 autopsy cases with consideration of diagnosis and surgical implications. Am J Cardiol. 1978;42:592–601.

    Article  CAS  PubMed  Google Scholar 

  • Schiebler GL, Edwards JE, Burchell HB, DuShane JW, Ongley PA, Wood EH. Congenital corrected transposition of the great vessels: a study of 33 cases. Pediatrics. 1961;27(Suppl):849–88.

    PubMed  Google Scholar 

  • Serraf A, Zoghbi J, Belli E, et al. Congenital mitral stenosis with or without associated defects: an evolving surgical strategy. Circulation. 2000;102:III166–71.

    Article  CAS  PubMed  Google Scholar 

  • Shone JD, Sellers RD, Anderson RC, Adams Jr P, Lillehei CW, Edwards JE. The developmental complex of “parachute mitral valve,” supravalvular ring of left atrium, subaortic stenosis, and coarctation of aorta. Am J Cardiol. 1963;11:714–25.

    Article  CAS  PubMed  Google Scholar 

  • Stellin G, Padalino M, Milanesi O, et al. Repair of congenital mitral valve dysplasia in infants and children: is it always possible? Eur J Cardiothorac Surg. 2000;18:74–82.

    Article  CAS  PubMed  Google Scholar 

  • Stellin G, Padalino MA, Vida VL, Boccuzzo G, Orrù E, Biffanti R, et al. Surgical repair of congenital mitral valve malformations in infancy and childhood: a single-center 36-year experience. J Thorac Cardiovasc Surg. 2010;140:1238–44.

    Article  PubMed  Google Scholar 

  • Uva MS, Galletti L, Gayet FL, Piot D, Serraf A, Bruniaux J, et al. Surgery for congenital mitral valve disease in the first year of life. J Thorac Cardiovasc Surg. 1995;109:164–74.

    Article  CAS  PubMed  Google Scholar 

  • Wood AE, Healy DG, Nolke L, Duff D, Oslizlok P, Walsh K. Mitral valve reconstruction in a pediatric population: late clinical results and predictors of long-term outcome. J Thorac Cardiovasc Surg. 2005;130:66–73.

    Article  PubMed  Google Scholar 

  • Yoshimura N, Yamaguchi M, Oshima Y, et al. Surgery for mitral valve disease in the pediatric age group. J Thorac Cardiovasc Surg. 1999;118:99–106.

    Article  CAS  PubMed  Google Scholar 

  • Zalzstein E, Hamilton R, Zucker N, et al. Presentation, natural history, and outcome in children and adolescents with double orifice mitral valve. Am J Cardiol. 2004;93:1067–9.

    Article  PubMed  Google Scholar 

  • Zias EA, Mavroudis C, Backer CL, Kohr LM, Gotteiner NL, Rocchini AP. Surgical repair of the congenitally malformed mitral valve in infants and children. Ann Thorac Surg. 1998;66:1551–9.

    Article  CAS  PubMed  Google Scholar 

  • Zweng TN, Bluett MK, Mosca R, Callow LB, Bove EL. Mitral valve replacement in the first 5 years of life. Ann Thorac Surg. 1989;47:720–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shahzad G. Raja BSc,MBBS(Hons.),MRCS,FRCS(C-Th) .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Raja, S.G., Wright, I.G. (2017). Congenital Mitral Valve Anomalies. In: Dabbagh, A., Conte, A., Lubin, L. (eds) Congenital Heart Disease in Pediatric and Adult Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-44691-2_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-44691-2_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44689-9

  • Online ISBN: 978-3-319-44691-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics