Left ventricular apical approach for the surgical treatment of congenital mitral stenosis

Barbero-Marcial, Miguel; Riso, Arlindo; Albuquerque, A T de; Atik, Edmar; Jatene, Adib

doi:10.1016/s0022-5223(19)33746-8

Cited by 25 publications

(28 citation statements)

References 5 publications

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“…An api cal incision was therefore mad e in the left ventricle. This incision was mad e 5 mm lateral from th e anterior de scending artery at the apex of the left ventricle and cont inued toward th e anterior and posterior asp ects of th e ventricula r wall, in the same manner as Barbero -Marcial and associat es have reported (1). The length of thi s incision was about 2.5 em.…”

Section: Case Repo Rtmentioning

confidence: 93%

“…Good exposure is necessa ry for mi tral valve repai r, but th is is difficult to achieve in children wi th congenital mitral stenosis. In pa rticular, a subvalvular obstructive lesion is impossible to evaluate by the at rial approach alon e. Barbero-Marcial and associates have reported good results usin g a left -ventricular apical approach for con genital mitral stenosis (1). Recent introduction of extended left atriotomy, such as the su perior-septal approach, for patients undergoin g mitra l valve repair has facilitated exposure of the mitral valve in the small left atrium (2,3,4).…”

Section: Introductionmentioning

confidence: 99%

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Mitral Valve Repair Through Combined Left Atrial and Ventricular Approach for Congenital Mitral Stenosis

Inaba¹,

Furuse²,

Kubota³

et al. 1997

Thorac cardiovasc Surg

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A 3-year-old boy underwent mitral valve repair for congenital mitral stenosis through combined superior-septal atriotomy and apical left ventriculotomy. The operation was performed safely with excellent exposure of the subvalvular apparatus by the ventricular approach, while sufficient visualization of the valvular lesion was obtained by the atrial approach. Postoperative echocardiography demonstrated normal left-ventricular motion and no residual mitral stenosis.

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Section: Case Repo Rtmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Mitral Valve Repair Through Combined Left Atrial and Ventricular Approach for Congenital Mitral Stenosis

Inaba¹,

Furuse²,

Kubota³

et al. 1997

Thorac cardiovasc Surg

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“…This is especially true in patients with abnormalities of the subvalvar apparatus. In this instance, reduced dimensions of the left atrium and mitral annulus, and frequent fusion of the commissures hamper exposure [18]. Based on these limitations, BARBERO-MARCIAL et al [18] proposed the apical left ventriculotomy as a surgical approach to the mitral valve.…”

Section: Discussionmentioning

confidence: 99%

“…In this instance, reduced dimensions of the left atrium and mitral annulus, and frequent fusion of the commissures hamper exposure [18]. Based on these limitations, BARBERO-MARCIAL et al [18] proposed the apical left ventriculotomy as a surgical approach to the mitral valve. The early results were excellent, in accordance to others [19].…”

Section: Discussionmentioning

confidence: 99%

“…Rev Bras Cir Cardiovasc 2003; 18(4): [312][313][314][315][316][317][318][319][320] Recent series in the literature have showed the safety of valve repair in most of the patients with CMS [8]. The hospital mortality [10,11,18,21,22] progressively improved, between zero and 12.5%. SERRAF et al [11] identified as independent predictors of mortality the staged procedure for associated anomalies and the presence of left ventricular outflow tract obstruction.…”

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confidence: 99%

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Surgical treatment of congenital mitral stenosis: medium-term results

Atik¹,

Duncan²,

Rosenthal³

et al. 2003

Rev Bras Cir Cardiovasc

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Objective: For a cohort of patients with congenital mitral stenosis (CMS), to determine: patient outcomes, predictors of valve repairability and predictors of durability of valve repair. Methods: From 1989 and 2002, 23 patients underwent surgical treatment of CMS, excluding those with common atrioventricular canal, and univentricular forms. The median age at operation was 15.5 months (range 2-204), and the median body weight was 11 Kg (range 4.5-51.6). Seventeen patients (73.9%) had associated anomalies, including Shone's complex in nine (39.1%) and pulmonary hypertension in 14 (60.9%). Mitral stenosis was severe in 14 patients (60.9%) and moderate in the remaining (median trans-mitral gradient of 16 mmHg, range 8.5-32). Mitral valve repair was performed in 18 patients (78.3%), and valve replacement in five (21.7%). Repair techniques included papillary muscle splitting (n=10), excision of supravalvular ring (n=9) and commissurotomy (n=8). Twelve patients (52.2%) required associated procedures.Results: There were no early and late deaths at a mean follow-up of 58.5 ± 46.7 months (range 1-156). Mean hospital stay was 12.7 ± 8.2 days. There were no significant factors associated with unsuccessful valve repair. Actuarial freedom from reoperation at five years was 67.1% (CI 95%: 56.8% to 77.4%). The mitral valve repair group required reoperation in eight patients (44.4%) (two early and six late), as opposed to one (20%) in the replacement group. The presence of preoperative pulmonary hypertension was significantly related (p<0.005) to higher reoperation rates. All but two the followed patients are presently in functional class I and the echocardiography has shown less than 2+ mitral stenosis and/or regurgitation.Conclusion: Reoperations were the most important cause of morbidity at the medium-term follow-up of CMS. Preoperative pulmonary hypertension may predict the need for reoperation after mitral valve repair, which is the procedure of choice in CMS. Rev Bras Cir Cardiovasc 2003; 18(4): 312-320 ATIK, FA ET AL -Surgical treatment of congenital mitral stenosis: Medium-term results Bras Cir Cardiovasc 2003; 18(4): 312-320 ATIK, FA ET AL -Surgical treatment of congenital mitral stenosis: Medium-term results Bras Cir Cardiovasc 2003; 18(4): 312-320 Descriptors: Mitral valve stenosis, congenital. Mitral valve stenosis, surgery. Mitral valve, abnormalities. Heart defects, congenital, surgery Rev Rev

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2003

The Natural and Modifed History of Congenital Heart Disease

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Left ventricular apical approach for the surgical treatment of congenital mitral stenosis

Cited by 25 publications

References 5 publications

Mitral Valve Repair Through Combined Left Atrial and Ventricular Approach for Congenital Mitral Stenosis

Mitral Valve Repair Through Combined Left Atrial and Ventricular Approach for Congenital Mitral Stenosis

Surgical treatment of congenital mitral stenosis: medium-term results

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