Rheumatic Valve Disease in Childhood and Adolescence: Surgical Treatment

¹ Thoracic-Cardiovascular Surgery Department, Beilinson Hospital, University of Tel-Aviv Medical School, Petah-Tiqva, Israel

Seventy-four children who suffered from rheumatic heart valve disease were operated upon during the years 1965-1971. Their ages ranged between 6 and 18 years; 35 were girls and 39 boys. Fifty-four children suffered mitral valve disease, 12 aortic, and eight from involvement of both valves. Six fell into class II, 37 in class III, and 31 in class IV, functional status prior to operation. Right or left heart catheterization or both were performed in 60 children. Severe pulmonary hvpertension was a common finding in ten children; the rate exceeded 80 mm Hg pressure in the pulmonary artery prior to operation. Thirty-two children underwent closed mitral commissurotomy, four open mitral repair, 18 mitral valve replacement, 12 aortic valve replacement and 8 replacement of two valves, or at least one replaced and one reconstructed. Three (4 percent) early and two (2.6 percent) late deaths occurred within this follow-up period. In the group of 38 children with heart valve replacement, postoperative emboli have occurred (10 percent) in four. All of these children have made a complete recovery. All the surviving 69 children have been followed-up for a period of one to eight years. Each showed significant improvement and has returned to school or normal activities or both.