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2001, Number 3

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Arch Cardiol Mex 2001; 71 (3)

Congenital mitral stenosis 1991-2001 experience

Alva C, González B, Meléndez C, Jiménez S, Jiménez D, David F, Sánchez A, Ortegón J, Ledesma M, Magaña JA, Argüero R

Language: Spanish
References: 16
Page: 206-213
PDF size: 208.92 Kb.


ABSTRACT

Objective: To describe ten years of experience with congenital mitral stenosis. Method: All cases with congenital mitral stenosis from January 1991 to 2001 were analized. Results: 16 patients with congenital mitral stenosis were found, mean age 3 ± 3.08 years. Types of obstructions: mitral commisures combined with tendinous cords fusion (45%), parachute mitral valve 37%, supravalvar mitral ring in one, fusion between papillary muscle and leaflets in one, and double mitral orifice in one. Hemodynamic (in mmHg) findings: wedge pressure 18.4 ± 4, pulmonary artery systolic 61 ± 21, diastolic 34 ± 15, mean 47 ± 18 mmHg, mean transvalvar gradient (MTG) 12.9 ± 7.3, PRU 5.5 ± 3.8. Four patients received medical treatment. Surgical results: Six patients underwent mitral repair, and four were subjected to mitral valve replacement (two with previous mitral repair). Global mortality was 2 (12.5%). Follow-up was 3.5 ± 3 years. There was a significant difference when the initial MTG 22.6 ± 11.5 mmHg before surgical repair was compared with the final MTG 4.75 ± 1.5 (P‹ 0.05), also when initial MTG 12 ± 2.3 before mitral valve replacement was compared with the final MTG 6 ± 1.15 mmHg (P‹ 0.05). Conclusion: Most patients are candidates for mitral surgical repair, however at mid term one third will require mitral valve replacement.


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