lock Open Access lock Peer-Reviewed




The surgical treatment of congenital mitral stenosis through a left ventriculotomy

Miguel Barbero-MarcialII; Arlindo RisoII; Ângelo AlbuquerqueI; Edmar AtikI; Adib D JateneI

DOI: 10.1590/S0102-76381991000300005


From June 1987 to October 1990, nine patients with congenital mitral stenosis (CMS) underwent surgical correction through an apical left ventriculotomy. Seven patients had parachute mitral valve and two had other forms of CMS. The surgical treatment of the mitral valve apparatus starts from below: first the papillary muscle is split and the cordae are divided and fenestrated. Then, the commissurotomies were performed through the ventricles aspect of the mitral valve. Associated anomalies were corrected simultaneously. There was no in-hospital death and only one late death (nonrelated). The echocardiography showed non significant residual stenosis and normal global function of the left ventricle. In conclusion, the appical left ventriculotomy is a good approach for treatment of CMS.


Entre junho de 1987 e outubro de 1990, nove pacientes consecutivos, portadores de estenose mitral congênita (EMC) foram submetidos a correção cirúrgica. Sete tinham valva mitral em paráquedas e dois, outras formas complexas de estenoses. Em todos, a via de abordagem foi a ventriculotomia apical esquerda, sendo dividido, primeiramente, o músculo papilar; depois, as cordas e, finalmente, as cúspides. As lesões associadas foram corrigidas prévia ou simultaneamente. Todos os pacientes tiveram boa evolução imediata. Houve um óbito tardio não relacionado. O estudo ecocardiográfico seriado pós-operatório mostrou adequada função ventricular esquerda. Conclui-se que esta via é de escolha para tratar lesões estenóticas congênitas complexas da valva mitral.
Full text available only in portuguese PDF format.


1. CARPENTIER, A.; BRANCHINI, B.; COUR, J.C.; VILLANI, M.; DELOCHE, A.; RELLAND, J.; D'ALLAINES, C.; BLONDEAU, P.; PIWNICA, A.; PARENZAN, L.; BROM, G. - Congenital malformations of the mitral valve in children: pathology and surgical treatment. J. Thorac Cardiovasc. Surg., 72: 854-866, 1990.

2. COLES, J.G.; WILLIAMS, W.G.; WATANABE, T.; DUNCAN, K.F.; SHERRET, H.; DASMAHAPATRA, H.K.; FREEDOM, R.M.; TRUSLER, G.A - Surgical experience with reparative techniques in patients with congenital mitral valvular anomalies. Circulation, 76 (Supl. 3): 117-122, 1987.

3. KEITH, J.D.; ROWE, R.D.; VLAP, P. - Heart disease in infancy and childhood. New York, MacMillan, 1958, p. 577.

4. LASKS, H.; HELLENBRAND, W.E.; KLEINMAN, C; TALVER, N.S. - Left atrial ventricle conduit for relief of congenital mitral stenosis in infancy. J. Thorac. Cardiovasc. Surg., 80: 782-787, 1980. [MedLine]

5. MITCHELL, I.M.; PRABHAKAR, G.; MAUGHAN, J.; TAYLOR, D.N. - Pulmonary artery versus left ventricular venting: a radioisotope study of left ventricular function. Ann. Thorac. Surg., 48: 699-703, 1989. [MedLine]

6. NADAS, A.S. & FYLER, D.C. - Pediatric cardiology. 3. ed. Philadelphia, W.B. Saunders, 1972. p. 683-687.

7. REPOGLE R.L.; KUNDLER H.; GROSS, R.E. - Left vintricular performance following apical left ventriculotomy. Arch. Surg., 95: 892-295, 1969.

8. SHONE, J.D.; SELLERS, R.D.; ANDERSON, R.C.; ADAMS Jr., P.; LILLEHEI, C.W.; EDWARDS, J.E. - The developmental complex of "parachute mitral valve", supravalvular ring of left atrium, subaortic stenosis and coarctation of aorta. Am. J. Cardiol., 11: 714-725, 1963. [MedLine]

9. TAGUCHI, K. & NAKAMURA, S. - Congenital mitral stenosis: report of three surgical cases and a review of the literature. Hiroshima J. Med. Sci., 16: 267-270, 1967.

CCBY All scientific articles published at are licensed under a Creative Commons license


All rights reserved 2017 / © 2019 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY