Re: Mitral Stenosis

Posted By CCF Cardio MD-SGM on May 09, 1998 at 22:22:36:

In Reply to: Mitral Stenosis posted by Mike Spencer on April 20, 1998 at 09:02:21:






My 11 week old daughter has just been diagnosed as having mitral stenosis, with the additional complication of a leak back through the mitral valve. Our doctor reccommends surgery to repair the stenosis but that the leak cannot be repaired.
This surgery will probably be done at some point in the next year to allow my daughter to grow but before her health deteriorates.
I am aware that mitral stenosis is more common in adults but I have found very little information on cases in children.
Please can you give me information on the number of cases of this type in young children that you have seen and that have been operated on. Also I would like to know the statistics for perfoming such an operation.
Thanks



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Dear Mr. Spencer,
Sorry about the delay in answering your question.   Mitral stenosis is very nicely treated with balloons in children, a procedure known as mitral valvuloplasty.  As with adults, the amount of mitral regurgitation may be prohibitive, since this tends to increase following the procedure.  However, this is usually not a problem.  Whether a balloon procedure can be performed depends very much on the appearance of the valve as seen by echocardiography, as certain characteristics predict a more favorable outcome with the valvuloplasty.  Also, it is critical to determine whether structures that lie beyond the mitral stenosis are also underdeveloped-- a corollary problem that is seen in many congenital heart lesions.   Valvuloplasty is a low-risk procedure in otherwise healthy infants.  The interventional cardiologist is best suited to estimate this risk, although I think it would be fair to say that serious undesirable outcomes occur less than 2-4% of the time.  
Regarding surgery to repair or replace the valve, it is preferred to avoid this as long as feasible in young adults and children, focusing on numerous clinical indicators to best judge when the procedure should take place.  The success rate for a surgical repair procedure is very highly influenced by the experience of the operator.  If you have this done in your area, I would insist on a surgeon with broad experience in the treatment of congenital heart lesions.
If you wish, we would be happy to make a recommendation at the Cleveland Clinic.  Please call the office of Dr. Larry Latson at 1-800 CCF CARE for an appointment.  Best of luck.  
Information in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your physician.