Congenital mitral stenosis with or without associated defects: An evolving surgical strategy.

摘要: Background —Congenital mitral stenosis (CMS) remains a surgical challenge, particularly when it is associated with other heart defects. As in groups of defects, there trend toward early single-stage complete repair, but the optimal approach unanswered. Methods and Results —This study was designed to analyze evolution strategies patients CMS defects through staged repair. Between 1980 1999, 72 children were operated on for congenital including CMS. Preoperative transmitral gradient 12.6±7 mm Hg. Preoperatively, all NYHA class III IV. Thirteen had an isolated CMS; 59, mainly ventricular septal defect (n=28) or multilevel left obstruction (n=41). In this group patients, 33 approach, 26 approach. Early mortality 12.5% (9 patients). There no deaths repair groups. Logistic regression revealed that influenced by association outflow tract ( P <0.001) use <0.01). late 2 6 Reoperation required 24 residual valve dysfunction obstruction. Including reoperations, 10 received prosthetic valve. At 15 years after surgery, survival 69.6±7.5%, freedom from reoperation 70.8±6.3%, replacement 69±6%. Conclusions —Surgery gives excellent long-term results. operation seems superior Mitral category should be reserved as salvage procedure.