Mid-Term Results of Congenital Supravalvar Mitral Ring Resection

Abstract

Supravalvar mitral ring is a surgically treatable cause of left ventricular inflow obstruction. Although residual gradients may be encountered in patients with mitral annular hypoplasia, surgical resection of the ring is encouraged.

Supravalvular mitral ring in a patient with Turner syndrome: A case report

“…Moreover, being younger than one year of age has been shown to be associated with poor surgical outcomes. [9] In their study, Yildirim et al [10] argued that, even in patients with mitral annulus hypoplasia, the stenosis gradient could be reduced to reasonable values only with effective ring resection. Our case had no major pathology related to the subvalvular apparatus, and the existing interchordal obliterations were corrected.…”

Supravalvar mitral ring with a parachute mitral valve and subcoarctation of the aorta in a child with hemodynamically significant VSD. A study of the morphology, echocardiographic diagnostics and surgical therapy

“…The „intravalvar‟ location of the stenosis which we found in the presented case seems to have worse prognosis in this regard. Therefore patients after supravalvar mitral ring surgery require many years of postoperative supervision ( 1 , 3 , 5 , 7 , 8 ) .…”

“…The approach through the opening of the anterior wall of the right atrium which is applied for the closing of the ventricular septal defect, does not allow for the surgical visualization of the interior of the left atrium nor of the mi- Wojciech Mądry, Maciej A. Karolczak, Krzysztof Grabowski tral valve and thus does not allow for the intraoperational verification of the diagnosis and for broadening the scope of the intervention. In patients with a supravalvar ring the stenosis has got a progressive nature, therefore over time it contributes to the generation of significant hemodynamic disorders, also in those children in which at the beginning the lesions were not severe (2,(5)(6)(7)(8) . On the other hand it has to be underlined that even precise resection of the pathological tissue from the atrial surface of the mitral valve leaflets does not completely normalize their mobility, nor does it fully restore laminar flow which -in the presence of the reduced cross-section of the mitral orifice in case of the parachute valve may lead to the recurrence of the stenosis (5) .…”