Efficacy of Artificial Chordal Reconstruction for Idiopathic Severe XXXX Due To @entity397 in Infancy.

@entity1 @entity339 @entity573 @entity28020 @entity397 @entity299 @entity736
Early surgical intervention is required for sudden onset, severe @entity339 ( @entity339 ) due to @entity397 in @entity1 with normal development younger than 1 year. The condition has been recognized as idiopathic. However, the surgical options in @entity1 are limited because of their size and somatic growth. We sought to examine the efficacy of mitral valve plasty by artificial chordal reconstruction for these @entity1 in mid-to-long term. From August 2005 through June 2012, 8 consecutive @entity1 aged 1-7 months underwent mitral valve plasty by chordal reconstruction using expanded @entity736 sutures for @entity339 , owing to leaflet prolapse. The geometric parameters of the diameter of the mitral annulus (D1), the long axis of the left ventricular (LV) chamber (D2), and the length of the papillary muscle including the reconstructed chordae (D3) were measured, as well as @entity339 grade (0-4) and LV end-diastolic dimension, at each time point. The parameters were compared with those in the control group that included @entity573 @entity1 without @entity299 and healthy @entity1 (n = 51). Mean follow-up period was 5.8 (2.8-9.6) years. Freedom from reoperation was 100%. @entity339 grades were 3.9    0.4 preoperatively, 2.4    0.9 at discharge, and 1.4    0.6 at the latest. Postoperative @entity339 was improved within 1 year in 5 of 6 @entity1 who had grade 2 or higher regurgitation. LV end-diastolic dimensions were 109% (% of normal), 113%, and 107% at discharge, 3, and 5 years, respectively. Geometric configuration indicated by the @entity28020 ratio did not significantly change with time. The length of the papillary muscle including reconstructed chordae (D3) strongly correlated with body surface area (r(2) = 0.65), which seemed to be equivalent to that in the control group. In conclusion, postoperative mitral valve function and geometry was preserved. This procedure with a low morbidity should be an option for pediatric @entity1 with acute severe @entity339 .
