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Closed mitral valvotomy in pregnancy--a Malaysian experience

Goon MS, Raman S, Sinnathuray TA

Aust N Z J Obstet Gynaecol, 1987 Aug;27(3):173-7.

Our experience from 1968 to 1985 in 12 women requiring closed mitral valvotomy during pregnancy is reviewed. All patients had severe mitral stenosis and were in functional class 3 (2 patients) or class 4 (10 patients). Mitral valvotomy was performed between the 18th and the 30th week of pregnancy using a transventricular dilator. Improvement in functional class was noted in all patients postoperatively. One patient had postvalvotomy mitral regurgitation and heart failure, which responded to diuretics; the subsequent course was uneventful. Eleven patients had normal deliveries; whilst one patient had a Caesarean section for an obstetric indication. All babies were normal and there was no maternal death. This series confirms that closed mitral valvotomy can be performed with an acceptable degree of safety during pregnancy, when indicated.

Matched MeSH terms: Rheumatic Heart Disease/surgery

Is it worth repairing rheumatic mitral valve disease in children? Long-term outcomes of an aggressive approach to rheumatic mitral valve repair compared to replacement in young patients

Krishna Moorthy PS, Sivalingam S, Dillon J, Kong PK, Yakub MA

Interact Cardiovasc Thorac Surg, 2019 02 01;28(2):191-198.

PMID: 30085022 DOI: 10.1093/icvts/ivy234

OBJECTIVES: Contemporary experience in mitral valve (MV) repair for children with rheumatic heart disease (RHD) is limited, despite the potential advantages of repair over replacement. We reviewed our long-term outcomes of rheumatic MV repair and compared them with the outcomes of MV replacement in children with RHD.

METHODS: This study is a review of 419 children (≤18 years) with RHD who underwent primary isolated MV surgery between 1992 and 2015, which comprised MV repair (336 patients; 80.2%) and MV replacement (83 patients; 19.8%). The replacement group included mechanical MV replacements (MMVRs) (n = 69 patients; 16.5%) and bioprosthetic MV replacements (n = 14 patients; 3.3%). The mean age with standard deviation at the time of operation was 12.5 ± 3.5 (2-18) years. Mitral regurgitation (MR) was predominant in 390 (93.1%) patients, and 341 (81.4%) patients showed ≥3+ MR. The modified Carpentier reconstructive techniques were used for MV repair.

RESULTS: Overall early mortality was 1.7% (7 patients). The mean follow-up was 5.6 years (range 0-22.3 years; 94.7% complete). Survival of patients who underwent repair was 93.9% both at 10 and 20 years, which was superior than that of replacement (P

Matched MeSH terms: Rheumatic Heart Disease/surgery*

Is rheumatic aetiology a predictor of poor outcome in the current era of mitral valve repair? Contemporary long-term results of mitral valve repair in rheumatic heart disease

Yakub MA, Dillon J, Krishna Moorthy PS, Pau KK, Nordin MN

Eur J Cardiothorac Surg, 2013 Oct;44(4):673-81.

PMID: 23447474 DOI: 10.1093/ejcts/ezt093

Contemporary experience with mitral valve (MV) repair in the rheumatic population is limited. We aimed to examine the long-term outcomes of rheumatic MV repair, to identify the predictors of durability and to compare the repair for rheumatic and degenerative MVs.

Matched MeSH terms: Rheumatic Heart Disease/surgery*

Comparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: is repair for "burnt-out" rheumatic disease still inferior to repair for degenerative disease in the current era?

Dillon J, Yakub MA, Kong PK, Ramli MF, Jaffar N, Gaffar IF

J. Thorac. Cardiovasc. Surg., 2015 Mar;149(3):771-7; discussion 777-9.

PMID: 25308120 DOI: 10.1016/j.jtcvs.2014.08.066

Mitral valve repair is perceived to be of limited durability for advanced rheumatic disease in adults. We aim to examine the long-term outcomes of repair for rheumatic disease, identify predictors of durability, and compare with repair for degenerative disease.

Matched MeSH terms: Rheumatic Heart Disease/surgery*

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