Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results

• Published in: Arquivos brasileiros de cardiologia Vol. 76; no. 3; pp. 215 - 220
• Main Authors: Lorier, Gabriel, Kalil, Renato A.K., Hoppen, Gustavo R., Barcellos, Christiano, Teleo, Nicolas, Homsi Netto, Abud, Gonzalez, Javier, Prates, Paulo R. L., Prates, Paulo R., Sant'Anna, João R. M., Nesralla, Ivo A.
• Format: Journal Article
• Language: English
• Published: Sociedade Brasileira de Cardiologia - SBC 01-03-2001; Sociedade Brasileira de Cardiologia (SBC)
• Subjects: CARDIAC & CARDIOVASCULAR SYSTEMS; congenital cardiopathy; mitral insufficiency; stenosis; surgery; valvuloplasty; valvuloplasty; mitral insufficiency; stenosis; congenital cardiopathy; surgery
• ISSN: 0066-782X; 1678-4170; 0066-782X; 1678-4170
• DOI: 10.1590/S0066-782X2001000300004

OBJECTIVE: To analyze late clinical evolution after surgical treatment of children, with reparative and reconstructive techniques without annular support. METHODS: We evaluated 21 patients operated upon between 1975 and 1998. Age 4.67±3.44 years; 47.6% girls; mitral insufficiency 57.1% (12 cases), stenosis 28.6% (6 cases), and double lesion 14.3% (3 cases). The perfusion 43.10±9.50min, and ischemia time were 29.40±10.50min. The average clinical follow-up in mitral insufficiency was 41.52±53.61 months. In the stenosis group (4 patients) was 46.39±32.02 months, and in the double lesion group (3 patients), 39.41±37.5 months. The echocardiographic follow-up was in mitral insufficiency 37.17±39.51 months, stenosis 42.61±30.59 months, and in the double lesion 39.41±37.51 months. RESULTS: Operative mortality was 9.5% (2 cases). No late deaths occurred. In the group with mitral insufficiency, 10 (83.3%) patients were asymptomatic (p=0.04). The majorit y with mild reflux (p=0.002). In the follow-up of the stenosis group, all were in functional class I (NYHA); and the mean transvalve gradient varied between 8 and 12mmHg, average of 10.7mmHg. In the double lesion group, 1 patient was reoperated at 43 months. No endocarditis or thromboembolism were reported. CONCLUSION: Mitral stenosis repair has worse late results, related to the valve abnormalities and associated lesions. The correction of mitral insufficiency without annular support showed good long-term results.