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The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 854-866, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
A Carpentier, B Branchini, JC Cour, E Asfaou, M Villani, A Deloche, J Relland, C D'Allaines, P Blondeau, A Piwnica, L Parenzan and G Brom
A systematic study of congenital mitral valve malformations was undertaken
on a surgical basis in an attempt to develop techniques of valvular
reconstruction adapted to the various lesions. Forty-seven children between
the ages of 4 months and 12 years (average 6 years, 4 months) have been
operated upon between January, 1970, and March, 1976. Valvular lesions were
classified into four group: Group I, mitral insufficiency owing to valvular
lesions: Group II mitral insufficiency with subvalvular lesions; Group III,
mitral insufficiency and stenosis; Group IV, stenosis. Associated lesions
(ventricular or atrial septal defects, coarctation, or aortic valve
stenosis) were present in 31 patients (65 per cent) and were corrected
during the same operation. Valve reconsruction was possible in 38 patients
whereas valve replacement was necessary in 9 patients. In the valve repair
group there were three operative deaths (8 per cent), no late deaths, one
reoperation for residual ventricular septal defect, and one myocardial
infarction. In the valve replacement group of 9 patients, there were three
operative deaths, three late deaths, and one case of repeated embolization.
Thirty-one of 38 patients in the valve repair group were classified into
Functional Class I after the operation (86 per cent), 2 were in Class II,
and one in Class III. Minimal or moderate regurgitation and cardiomegaly
persisted in the majority of the patients. Pulmonary artery pressure
significantly decreased, however, as demonstrated by postoperative
catheterization in 17 patients.
ARTICLES
Congenital malformations of the mitral valve in children. Pathology and surgical treatment
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