Conservative Surgery for Congenital Abnormalities of the Mitral Valve
In congenital abnormalities of the mitral valve, repair is the goal of surgical management. Between 1975 and 1987 ten patients aged between 4 months and 14 years underwent surgical treatment. Seven children had mitral stenosis, six had supravalvar rings, and one had parachute valve. Five exhibited either two or three of the features of the Shone complex. Conservative surgery was successful in six cases and mitral valve replacement was required in one patient with supravalvar ring leading to the only operative death in this series. Of the six survivors, one is abroad and lost to follow-up, and one required mitral valve replacement 5 years later. After 2–138 months all are asymptomatic despite two having a systolic murmur, and one cardiomegaly and valve thickening on echocardiography. Two children had isolated mitral incompetence, each with a giant left atrium causing airway obstruction and pulmonary complications; both valves were repaired. After 7 and 5 years, respectively, both are asymptomatic. The final patient had redundant mitral tissue causing subaortic obstruction. This tissue was excised and the valve repaired; the patient remains well and asymptomatic. Conservative surgery was possible and had a good outcome in nine out of ten cases with severe congenital mitral valve anomalies.
KeywordsMitral Valve Mitral Stenosis Conservative Surgery Mitral Valve Replacement Anterior Cusp
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