Mitral clefts and interatrial septum defects: 15-year results.
Between 1985 and 2002, 60 patients (58% female) with a mean age of 20.3 +/- 12.1 years (range, 2-55 years) were treated for anterior mitral leaflet cleft. There was a primum atrial septal defect in 52 patients (87%) and a secundum type in 8 (13%). Concomitant cardiac defects were patent foramen ovale in 6 patients, cleft tricuspid valve in 3, ventricular septal defect in 2, cor triatriatum in 1, and persistent left superior vena cava in 1. Mean grade (1-4) of mitral insufficiency was 2.28 +/- 0.74. Atrial septal defects were closed with a pericardial patch in 45 patients, with a prosthetic patch in 11, and primarily in 4. Mitral leaflet clefts were repaired using interrupted sutures. There was no early or late mortality. Two patients (3%) needed a permanent pacemaker. Postoperatively, severe (> or =grade 3) mitral insufficiency developed in 2 patients; valve replacement was performed in one, cleft recurrence and leakage from the patch were treated in the other. Freedom from reoperation was 92.2% +/- 5.6% at 15 years. Surgical intervention can be performed for congenital anterior mitral leaflet cleft and interatrial septal defect with good results in both pediatric and adult age groups.
Kirali
Kaan
K
Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, Kadikoy 81020, Istanbul, Turkey. imkkirali@yahoo.com
Mansuroğlu
Denyan
D
Ozen
Yücel
Y
Bozbuğa
Nilgün Ulusoy
NU
Tuncer
Altuğ
A
Toker
Mehmet Erdem
ME
Sişmanoğlu
Mesut
M
Yakut
Cevat
C
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004694:Endocardial Cushion Defects / Q000150:complications / Q000601:surgery*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000002:abnormalities* / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques; D016896:Treatment Outcome