title: Intermittent annular reduction with Alfieri's repair in the treatment of mitral insufficiency in children: initial results.
abstract: OBJECTIVE
  Mitral valve insufficiency must be treated by repair whenever as possible as it provides better results - especially within the pediatric population in order to avoid valve replacement inconvenients. The aim of this study is to describe mitral valve repair technique based on an anatomical and functional approach.
  
  
  METHODS
  During a 13 months period, eight children (age ranged from 2 and 12 years old 6.37 +/- 3.66) with mitral valve insufficiency underwent intermittent anterior and posterior annuloplasty associated with Alfieri's repair - performed by placing a stitch between the anterior and posterior leaflets in the point of maximal regurgitation thus creating a double orificial mitral valve.
  
  
  RESULTS
  There were no surgical deaths. All patients underwent postoperative echocardiography. Three patients showed mild mitral valve insufficiency and five patients showed no insufficiency. The time in intensive care unit ranged from 2 to 4 days (2.5 +/- 0.75), and the time of stay in hospital ranged from 5 to 8 days (6.37 +/- 1.06).
  
  
  CONCLUSIONS
  In spite of the little sample size, the proposed technique proved itself to be simple and effective in the treatment of single mitral valve insufficiency within the pediatric population. In addition, it also yielded satisfactory immediate results. Long-term follow-up is nevertheless necessary in order to evaluate long-term results.
authors.affiliation: Pediatric Cardiac Surgery and Congenital Heart Diseases Department at Santa Marcelina Hospital, Itaquera, São Paulo, SP, Brazil. moise.dalva@gmail.com
authors.forename: Moise
authors.initials: M
authors.lastname: Dalva
authors.forename: Grace Caroline Van Leeuwen
authors.initials: GC
authors.lastname: Bichara
authors.forename: Carlos Edson Campos
authors.initials: CE
authors.lastname: Cunha Filho
authors.forename: Gustavo Fernandes
authors.initials: GF
authors.lastname: Carneiro
authors.forename: Gustavo Niankowsky
authors.initials: GN
authors.lastname: Saliba
authors.forename: José Arteaga
authors.initials: JA
authors.lastname: Camacho
authors.forename: José Viera
authors.initials: JV
authors.lastname: Zárate
authors.forename: Renán Prado
authors.initials: RP
authors.lastname: Límaco
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome