title: Acute progressive mitral regurgitation resulting from chordal rupture in infants.
abstract: This report describes six previously healthy infants with acute mitral valve chordal rupture. Although their initial symptoms were mild respiratory distress and fever, all the infants presented with acute progressive left heart failure and required urgent surgical repair. Mitral valve annuloplasty and mitral valve replacement were performed (for three patients each). Two patients died, both of whom had cardiac arrest and required resuscitation before surgery. Histologic examination of excised mitral valve leaflets showed infiltration of gram-positive bacteria in these two patients. All the patients were 4-6 months old, which may suggest underlying congenital factors. The authors believe early diagnosis and surgery are crucial as a life-saving measure for infants with acute mitral valve chordal rupture.
authors.affiliation: Division of Cardiology and Pediatric Cardiovascular Surgery, National Medical Center for Children and Mothers, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Asakai
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Masahide
authors.initials: M
authors.lastname: Kaneko
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Misaki
authors.forename: Ikuya
authors.initials: I
authors.lastname: Achiwa
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Hirata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kato
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D002815:Chordae Tendineae / Q000601:surgery; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012422:Rupture, Spontaneous