[Congenital mitral stenosis. Experience in 1991-2001].
OBJECTIVE
To describe ten years of experience with congenital mitral stenosis.


METHODS
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).


CONCLUSIONS
Most patients are candidates for mitral surgical repair, however at mid term one third will require mitral valve replacement.
Alva
C
C
Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. alval@prodigy.net.mx
González
B
B
Meléndez
C
C
Jiménez
S
S
Jiménez
D
D
David
F
F
Sánchez
A
A
Ortegón
J
J
Ledesma
M
M
Magaña
J A
JA
Argüero
R
R
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008946:Mitral Valve Stenosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography