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ORIGINAL CONTRIBUTIONS |
lu, MD
a, MD
Tuncer, MD
i
mano
lu, MD
Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, Istanbul, Turkey
For reprint information contact: Kaan Kirali, MD Tel: 90 216 326 6969 Fax: 90 216 339 0441 email: imkkirali{at}yamoo.com Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, Kadikoy 81020, Istanbul, Turkey.
Between 1985 and 2002, 60 patients (58% female) with a mean age of 20.3 ± 12.1 years (range, 255 years) were treated for anterior mitral leaflet cleft. There was a primum atrial septal defect in 52 patients (87%) and a secundum type in 8 (13%). Concomitant cardiac defects were patent foramen ovale in 6 patients, cleft tricuspid valve in 3, ventricular septal defect in 2, cor triatriatum in 1, and persistent left superior vena cava in 1. Mean grade (14) of mitral insufficiency was 2.28 ± 0.74. Atrial septal defects were closed with a pericardial patch in 45 patients, with a prosthetic patch in 11, and primarily in 4. Mitral leaflet clefts were repaired using interrupted sutures. There was no early or late mortality. Two patients (3%) needed a permanent pacemaker. Postoperatively, severe (
grade 3) mitral insufficiency developed in 2 patients; valve replacement was performed in one, cleft recurrence and leakage from the patch were treated in the other. Freedom from reoperation was 92.2% ± 5.6% at 15 years. Surgical intervention can be performed for congenital anterior mitral leaflet cleft and interatrial septal defect with good results in both pediatric and adult age groups.
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