title: Submitral aneurysm in children.
abstract: BACKGROUND
  We report a surgical series of submitral aneurysm in children.
  
  
  METHODS
  Between March 2011 and December 2015, eight consecutive patients less than 18 years old with submitral aneurysm underwent surgical correction.
  
  
  RESULTS
  Six patients were female, the mean age was 7 ± 3.8 years old, and mean weight was 21.4 kg. Six patients were in NYHA functional class III or IV. Six patients underwent repair via a transatrial approach, another with a transatrial combined with transaneurysmal approach, and another with a transventricular approach. There were no in-hospital deaths but one 30-day mortality. One patient required reoperation. Two patients required mitral valve replacement. At discharge, one patient had severe and another had moderate mitral regurgitation. The mean follow-up time was 26.4 months and five patients were alive. No reintervention was required.
  
  
  CONCLUSIONS
  Submitral aneurysm is not restricted to adults. Heart failure is the commonest clinical presentation in the pediatric age. The transatrial approach is feasible, safe, and associated with good short-term results. The mitral valve can be preserved in the majority of cases.
authors.affiliation: Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.
authors.forename: Valdano
authors.initials: V
authors.lastname: Manuel
authors.affiliation: Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.|Hospital Cruz Vermelha, Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Sousa-Uva
authors.affiliation: Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.
authors.forename: Gade
authors.initials: G
authors.lastname: Miguel
authors.affiliation: Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.|Hospital Cruz Vermelha, Lisbon, Portugal.
authors.forename: Manuel Pedro
authors.initials: MP
authors.lastname: Magalhães
authors.affiliation: Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.
authors.forename: Albino
authors.initials: A
authors.lastname: Pedro
authors.affiliation: Cardio-Thoracic Center, Clínica Girassol, Luanda, Angola.
authors.forename: António Pedro Filipe
authors.initials: AP
authors.lastname: Júnior
authors.affiliation: Department of Cardiology, Hospital Militar Principal/Instituto Superior, Luanda, Angola.
authors.forename: Humberto
authors.initials: H
authors.lastname: Morais
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006322:Heart Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed