Incidence and Risk Factors for Mitral Valve Prolapse in Severe Adolescent Idiopathic Scoliosis

Dhuper, Sarita; Ehlers, Kathryn H.; Fatica, Nunzia S.; Myridakis, Dorothy; Klein, Arthur A.; Friedman, Deborah; Levine, Daniel

doi:10.1007/s002469900220

Cited by 26 publications

(23 citation statements)

References 10 publications

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“…This study showed that valvular disease, mainly MVP, was the most frequent abnormity in Chinese CS patients, which had not been described previously. Dhuper et al [9] suggested that the thorax abnormity in idiopathic scoliosis patients may cause the change of the heart shape and subsequently may lead to the mitral valve prolapse. We supported this assumption in CS patients.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of congenital scoliosis and associated cardiac and intraspinal abnormities in a Chinese population

et al. 2011

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Our objective is to assess the incidence of cardiac and intraspinal abnormities in Chinese congenital scoliosis (CS) patients and to study the relationship between the associated abnormities and the different CS types. Fivehundred and thirty-nine consecutive Chinese patients with CS were retrospectively studied, and the records of echocardiography, plain radiograph of the entire spine, magnetic resonance imaging of the entire spine and/or myelogram were reviewed. The results indicated that the incidence of cardiac and intraspinal abnormities in CS patients was 14.1 and 24.5%, respectively. There was no difference in the incidence of associated cardiac and intraspinal abnormities in different CS types (P [ 0.05). The most common cardiac abnormities in CS patients was mitral valve prolapse, which was followed by congenital heart diseases, including atrial septal defect, ventricular septal defect, bicuspid aortic valve and patent ductus ateriosus. The cardiac abnormities were not likely to be concurrent with intraspinal abnormities in CS patients (P = 0.04). The intraspinal abnormities were more common in female and older patients (all P \ 0.05). One or more abnormities mentioned above could be found in 36.8% CS patients and were more likely to be found in female patients (P \ 0.01). We concluded that CS is not a simple abnormity, due to the high incidence of associated deformities of other organs, comprehensive assessment was strongly recommended before the surgical correction for CS patients.

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Section: Discussionmentioning

confidence: 99%

A retrospective study of congenital scoliosis and associated cardiac and intraspinal abnormities in a Chinese population

et al. 2011

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“…The prevalence of MR was 15.9%, TR 47.4%, and PR 28.3%. In adolescent idiopathic scoliosis (AIS), the prevalence of cardiac valve abnormalities has been reported as 13% to 28% 20,21) . Our study suggests that NMS patients have a higher prevalence of valvular abnormalities than AIS patients.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Preoperative Echocardiographic Evaluation and Spinal Deformity in Patients with Neuromuscular Scoliosis

Saito

Inoue

Imura

et al. 2018

Spine Surg Relat Res

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Abstract:Introduction: Echocardiography is an important component of perioperative cardiac risk stratification in patients with neuromuscular scoliosis (NMS). However, there are little data regarding the relationship between preoperative echocardiographic findings and spinal deformity. We retrospectively reviewed preoperative echocardiographic data to investigate the relationship between echocardiographic evaluation and spinal deformity in NMS.Methods: We reviewed 73 NMS patients (mean age: 13.3 years, male 66%) who underwent spinal correction surgery between 2008 and 2016. Echocardiographic data including ejection fraction (EF), valvar disease, and inferior vena cava diameter were collected from the preoperative exam. Demographic and radiographic data were also collected.Results: Preoperative diagnoses included Duchenne muscular dystrophy, Fukuyama congenital muscular dystrophy, other dystrophy, spinal muscular atrophy, and congenital myopathies. Mean Body Mass Index (BMI) was 15.6 kg/m 2 . Mean major Cobb angle before surgery was 86.6 ± 28.2°. Because of technical difficulty, complete echocardiographic data could only be collected and evaluated in 49.3% of patients. Neither right nor left sided cardiac evaluation could be completed in 20.5%. Patients in whom complete echocardiographic data could not be collected had significantly more extensive thoracic scoliosis with a more rigid curve and hypokyphosis, and were of lower weight and BMI than patients in whom complete data could be collected. Ten cases (13.7%) were diagnosed as having minor heart-related complications immediately after surgery, and they had higher right atrial pressures preoperatively.Conclusions: Echocardiography can be technically difficult in NMS patients with extensive spinal deformities. We found that perioperative cardiac function could only be evaluated by echocardiogram in about half of NMS patients undergoing spinal correction surgery. The absence of an adequate preoperative cardiac evaluation could render these patients more susceptible to perioperative heart-related complications. Echocardiography may not be sufficient to evaluate cardiac conditions in children with extensive NMS.

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“…Studies have reported cardiac valvular abnormalities, including mitral valve prolapse, in patients with AIS [5,6,12,13]. The prevalence of cardiac valvular abnormalities, and specifically mitral valve prolapse, is higher in patients with a strong family history of scoliosis [6] or with other known comorbidities, including anorexia nervosa, psoriasis, cystic fibrosis, and spondylolisthesis [5].…”

Section: Introductionmentioning

confidence: 99%

Routine Preoperative Echocardiograms in Select Patients with Adolescent Idiopathic Scoliosis Rarely Show Abnormalities and do not Predict Adverse Cardiovascular Events

Rao¹

2017

MOJOR

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Study Design: Retrospective Objectives: The prevalence and clinical significance of cardiac abnormalities detected on ECHO in surgically treated AIS patients is unclear. Our goals were to determine the prevalence of cardiac abnormalities detected on echocardiography (ECHO) in patients undergoing surgery for adolescent idiopathic scoliosis (AIS). Further, we aimed to determine whether preoperative curve magnitude is associated with abnormal ECHO findings and whether ECHO abnormalities are associated with perioperative cardiovascular complications. Methods:We reviewed clinical records of 619 patients aged 10 to 18 years with AIS who underwent spinal fusion from 2000 through 2015. Indications for ECHO were a major curve greater than 70º or recommendation by primary care providers. Major curve magnitudes were calculated using Cobb angles. We assessed for adverse perioperative cardiovascular events. Statistical significance was tested using Student t test with an alpha level of <.05.Results: Forty-three (7 %) patients had a preoperative ECHO within 6 months before surgery (23 normal ECHOs, 16 normal variants (including trivial valvular abnormalities), and 4 abnormal ECHOs (all mild functional or structural abnormalities). There was no association between presence of cardiac abnormalities and major curve magnitude (p = .38). There were no documented perioperative adverse cardiovascular events in any of the 43 cases nor in the 576 patients who did not have preoperative ECHOs. Conclusion:Patients with abnormal ECHOs did not experience perioperative cardiovascular events. Curve magnitude was not associated with abnormal ECHO findings. Routine preoperative ECHOs in AIS patients based on curve magnitude did not change management in these patients.

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Incidence and Risk Factors for Mitral Valve Prolapse in Severe Adolescent Idiopathic Scoliosis

Cited by 26 publications

References 10 publications

A retrospective study of congenital scoliosis and associated cardiac and intraspinal abnormities in a Chinese population

A retrospective study of congenital scoliosis and associated cardiac and intraspinal abnormities in a Chinese population

The Relationship between Preoperative Echocardiographic Evaluation and Spinal Deformity in Patients with Neuromuscular Scoliosis

Routine Preoperative Echocardiograms in Select Patients with Adolescent Idiopathic Scoliosis Rarely Show Abnormalities and do not Predict Adverse Cardiovascular Events

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