Surgical mitral valve repair in children with rheumatic fever.
BACKGROUND
Mitral repair is well accepted in children with rheumatic fever.


OBJECTIVE
To analyze the outcomes of surgical mitral repair in children with rheumatic lesions after four years of follow-up.


METHODS
Retrospective study of 40 patients younger than 18 years, who underwent surgery in the National Institute of Cardiology (Rio de Janeiro) between January 1998 and January 2003. The echocardiographic degree of mitral regurgitation; surgical technique used; pre and postoperative functional class; patient outcome; need for valve replacement; and deaths were analyzed.


RESULTS
Twenty one patients (52.5%) were females. Severe mitral regurgitation was observed in 32 patients (80%) and moderate in eight (20%). Three immediate deaths occurred (7.5%). Three months after surgery, echocardiography showed no valve regurgitation or mild regurgitation in 35 of 37 cases (94.6%) patients, and severe regurgitation in two (5.2%). Thirty three cases (82.5%) were in functional class III or IV in the preoperative period, and three months after surgery all the 37 cases (100%) were in functional class I or II. The differences between the degree of mitral regurgitation and functional class in pre and postoperative periods were statistically significant (p<0.01). Seven (19%) patients underwent heart valve replacement before four years of follow-up.


CONCLUSIONS
Mitral valve repair showed favorable results in most of the cases as regards the degree of mitral regurgitation and the pre and postoperative functional class. Only 19% of the patients required surgical valve replacement before four years of follow-up.
Rocha e Silva
Andréa
A
Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brasil.
Herdy
Gesmar Volga Haddad
GV
Vieira
Alan Araujo
AA
Simões
Luiz Carlos
LC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome