Mitral Valve Replacement in Children
The malignant type of rheumatic fever rampant in the young in countries with poor socioeconomic conditions most commonly damages the mitral valve. Juvenile mitral stenosis in these regions is often encountered, and mitral commissurotomy in children is frequently carried out [1–4]. In most children, the closed approach is preferred, yieldieng excellent results (see chapter on “Closed mitral commissurotomy in children”) and necessitating less sophisticated surgical facilities. Furthermore, the demand for expert manpower and the financial outlay are significantly reduced - factors of considerable importance in the less affluent countries. Mitral insufficiency and certain cases of mitral stenosis considered unsuitable for closed commissurotomy must be managed by direct vision surgery using total cardiopulmonary bypass. The choice of operation, i.e., conservative repair or valve replacement, depends not only on the pathologic condition of the valve but also on the experience of the surgical team with a particular method. Results should be compared and conclusions drawn, bearing in mind that the ultimate aim of the surgeon is to relieve or alleviate suffering and prolong life.
KeywordsAtrial Fibrillation Mitral Valve Valve Replacement Rheumatic Fever Mitral Stenosis
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