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

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), s...

Full description

Bibliographic Details
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: Article
Language:English
Published: Sociedade Brasileira de Cardiologia (SBC) 2001-01-01
Series:Arquivos Brasileiros de Cardiologia
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2001000300004
_version_ 1819178015119114240
author 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.
author_facet 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.
author_sort Lorier Gabriel
collection DOAJ
description 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.
first_indexed 2024-12-22T21:35:49Z
format Article
id doaj.art-19671c3b09b042d4a3ee7a61d94c4e74
institution Directory Open Access Journal
issn 0066-782X
1678-4170
language English
last_indexed 2024-12-22T21:35:49Z
publishDate 2001-01-01
publisher Sociedade Brasileira de Cardiologia (SBC)
record_format Article
series Arquivos Brasileiros de Cardiologia
spelling doaj.art-19671c3b09b042d4a3ee7a61d94c4e742022-12-21T18:11:46ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia0066-782X1678-41702001-01-01763215220Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical resultsLorier GabrielKalil Renato A.K.Hoppen Gustavo R.Barcellos ChristianoTeleo NicolasHomsi Netto AbudGonzalez JavierPrates Paulo R. L.Prates Paulo R.Sant'Anna João R. M.Nesralla Ivo A.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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2001000300004congenital cardiopathyvalvuloplastysurgerystenosismitral insufficiency
spellingShingle 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.
Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results
Arquivos Brasileiros de Cardiologia
congenital cardiopathy
valvuloplasty
surgery
stenosis
mitral insufficiency
title Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results
title_full Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results
title_fullStr Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results
title_full_unstemmed Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results
title_short Unsupported valvuloplasty in children with congenital mitral valve anomalies. Late clinical results
title_sort unsupported valvuloplasty in children with congenital mitral valve anomalies late clinical results
topic congenital cardiopathy
valvuloplasty
surgery
stenosis
mitral insufficiency
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2001000300004
work_keys_str_mv AT loriergabriel unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT kalilrenatoak unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT hoppengustavor unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT barcelloschristiano unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT teleonicolas unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT homsinettoabud unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT gonzalezjavier unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT pratespaulorl unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT pratespaulor unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT santannajoaorm unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults
AT nesrallaivoa unsupportedvalvuloplastyinchildrenwithcongenitalmitralvalveanomalieslateclinicalresults