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  • Preoperative left ventricular end systolic dimension as a predictor of postoperative ventricular dysfunction in children with mitral regurgitation

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Preoperative left ventricular end systolic dimension as a predictor of postoperative ventricular dysfunction in children with mitral regurgitation
  1. J Y Lee1,
  2. C I Noh2,
  3. E J Bae2,
  4. Y S Yun2,
  5. J R Lee3,
  6. Y J Kim3
  1. 1Department of Pediatric Cardiology, Sejong Heart Institute, Sejong General Hospital, Pucheon, Korea
  2. 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
  3. 3Department of Cardiovascular Surgery, Seoul National University College of Medicine
  1. Correspondence to:
    Dr Chung Il Noh, Department of Pediatrics, Seoul National University Children’s Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea;
    ksydhnoh{at}medimail.co.kr

https://doi.org/10.1136/heart.89.10.1243

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    The timing of surgery has been a major problem in the management of chronic severe mitral regurgitation (MR). In adults, because of poor prognosis of postoperative left ventricular (LV) dysfunction, sequential echocardiographic assessment of LV function for optimal operation time is recommended.1,2 However, in children, therapeutic guidelines of chronic MR are less well defined and severe symptoms are often used as the indication for surgery. Furthermore, report on the change of LV function after mitral valve (MV) surgery is very limited.3 Therefore we analysed the records of children who had MV surgery for severe MR to evaluate the change of LV function and to identify any potential risk variable for late postoperative LV dysfunction.

    METHODS

    A retrospective study was done in 40 consecutive patients (20 boys, 20 girls) who had MV surgery for isolated severe MR. Fourteen patients with residual MR after correction of other cardiac defects were included (atrioventricular septal defects in 10, ventricular septal defect in 3, double outlet right ventricle in 1). Surgery for MR was done after a mean (SD) of 3.9 (3.1) years (range 5 months to 8.4 years) since the previous operation. Fourteen patients had rheumatic MR; 8, congenital isolated MR; 2, Marfan syndrome with MR; 1, endocarditic MR with William’s syndrome, and 1, …

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