Congenital mitral valve stenosis means a narrowing of the mitral valve. This valve controls blood flowing from the heart’s left atrium to the left ventricle.
The narrow opening reduces the amount of blood that can flow into the left ventricle, which causes the blood to back up into the left atrium and the lungs. The result can be fatigue and short of breath. Blood held back in the left atrium causes that chamber to enlarge. Fluid also will build up in the lungs.
Mitral valve stenosis in children can be congenital or caused by damage from rheumatic fever, an infectious disease complication from strep throat.
For many children, the first hint of mitral valve stenosis will be a heart murmur. Your child’s doctor can hear a heart murmur with a stethoscope during a routine examination. An echocardiogram can provide more detail regarding your child’s heart murmur.
In severe cases, your child may need a valvuloplasty or open heart surgery to fix or replace the valve. The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, have the experience and skills to diagnose mitral valve stenosis and provide a treatment plan specifically for your child.
Norton Children’s Heart Institute specialists can identify whether your child’s congenital mitral valve stenosis is mild or severe. In minor cases, it may be enough to simply watch its progress and possibly give medication to lessen its effects. In other cases, more invasive procedures may be necessary.
Norton Children’s Heart Institute is the leading provider of pediatric heart care in Louisville and Southern Indiana.
Balloon Valvuloplasty for Congenital Mitral Valve Stenosis
One potential treatment for mitral valve stenosis is called a balloon valvuloplasty. Your child will be sedated (asleep) for the procedure. A specially trained pediatric cardiac anesthesiologist with give the anesthesia and closely monitor your child.
A pediatric cardiac interventional cardiologist at Norton Children’s Heart Institute will insert a catheter — a long, thin tube — into your child’s blood vessels and thread it up to the heart and the precise site of the faulty mitral valve. They will then inflate a tiny balloon attached to the catheter to widen the passage through the valve. They will then remove the catheter and the balloon.
Valve Replacement Surgery
Mitral valve replacement is a more invasive surgery than a balloon valvuloplasty. Your child’s surgeon may need to remove the narrowed valve and replace it with a mechanical valve or a donor valve.
Your child will be sedated (asleep). A pediatric cardiac anesthesiologist will give the sedation medication and closely monitor your child during the procedure. An incision is made in the middle of the chest, and the child is placed on a heart-lung (cardiopulmonary) bypass machine. This machine does the heart’s work of pumping blood and the lungs’ work of exchanging gases (oxygen and carbon dioxide) while the surgeons operate.
The heart is then opened through a skilled incision, allowing the pediatric cardiothoracic surgeon to view the mitral valve. The valve is replaced with a mechanical valve or donor valve, and then the heart and chest are closed.
Depending on the type of replacement valve used and the child’s age, your child may future surgeries. He or she also could need to take blood-thinning (anticoagulation) medications long-term.
The specialists at Norton Children’s Heart Institute will follow your child after these procedures and be able to provide answers to your questions before you leave the hospital.