title: Long-term Results After Open Mitral Commissurotomy for a One-Month-Old Infant With Mitral Stenosis.
abstract: The strategy for an infant with congenital mitral stenosis should be determined by three important factors: left ventricular volume, the degree of the systemic outflow tract obstruction, and the type of mitral valve dysfunction. A successful staged biventricular repair in early infancy for a patient who had congenital mitral stenosis with short chordae, hypoplastic left ventricle and coarctation of the aorta, and the long-term results are described. There were the following important hemodynamic factors that led to the successful biventricular repair in the patient. Total systemic output was barely supplied through the hypoplastic left ventricle after closure of the ductus arteriosus on admission. The neonate underwent repair of coarctation of the aorta alone as the initial stage at 9 days after birth. Also, spontaneous closure of the foramen ovale following repair of coarctation of the aorta accelerated the progressive left ventricular growth. Open mitral commissurotomy with an interatrial fenestration using the modified Brawley's approach was performed for a 40-day-old infant. Good left ventricular growth and good mitral valve function have been observed for 18 years after open mitral commissurotomy. Appropriate early augmentation of left ventricular inflow through the mitral valve might be effective for growth of a hypoplastic left ventricle. J. Med. Invest. 64: 187-191, February, 2017.
authors.affiliation: Department of Cardiovascular Surgery, Graduate School of Biomedical Sciences, Tokushima University.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitaichi
authors.forename: Mikio
authors.initials: M
authors.lastname: Sugano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Arase
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kawatani
authors.forename: Kanako
authors.initials: K
authors.lastname: Kameta
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kurobe
authors.forename: Eiki
authors.initials: E
authors.lastname: Fujimoto
authors.forename: Akemi
authors.initials: A
authors.lastname: Ono
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hayabuchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sogabe
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kitagawa
mesh_terms: D000293:Adolescent; D001017:Aortic Coarctation / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging / Q000601:surgery; D007231:Infant, Newborn; D008943:Mitral Valve / Q000002:abnormalities*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008946:Mitral Valve Stenosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome