Resumo

ALVA, Carlos et al. Congenital mitral stenosis 1991-2001 experience. Arch. Cardiol. Méx. [online]. 2001, vol.71, n.3, pp.206-213. ISSN 1665-1731.

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.

Palavras-chave : Congenital mitral stenosis; Parachute mitral valve; Valve mitral replacement in children.