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Gaceta Médica Boliviana

versão impressa ISSN 1012-2966versão On-line ISSN 2227-3662

Resumo

VENTURA QUIROGA, Ernesto  e  ARZE A, Lorena. Congenital mitral valve displasic, case report. Gac Med Bol [online]. 2013, vol.36, n.2, pp.100-104. ISSN 1012-2966.

Congenital dysplasia of the mitral valve, outstanding genetic abnormality in the composition of collagen, which affects blood flow of the left ventricle to the left atrium in systole, with high mortality without early surgical approach. We report the case of a rural area of 4 years with heart murmur discovered at 4 months and not investigated. A year, crying and sucking dyspnea, diaphoresis, and difficulty gaining weight, mitral valve dysplasia with regurgitation, pulmonary hypertension ( 70 mm Hg ) with surgical indication. Sign up under treatment for heart failure, cachectic, with dyspnea at rest, orthopnea, cyanosis, chest bulging hyperdynamic shock prominent peak in the 7th intercostal space and left anterior axillary line. Mitral systolic murmur 4/6 with radiation to axilla, pulmonary systolic murmur 2/6. Important hepatomegaly. Distal coldness. Chest X-ray : Cardiomegaly 4/IV, ICT 0.72. Pulmonary vascular redistribution. EKG: biatrial and biventricular significant growth with FC 140x'. Echocardiogram significant growth in the four chambers. Patent ductus arteriosus . Mitral valve leaflets thickened, calcified, anterior and posterior cord redundant short, anterior leaflet prolapse and later re-tracted, regurgitation 4+/4+. Tricuspid valve regurgitation with important. 90mmHg systolic pulmonary pressure. Preoperative: me-chanical ventilation , inotropic support, furosemide infusion. Surgical correction: mitral valve replacement with a mechanical prosthesis , tricuspid plasty, ductus closure, CIA discharge opening. Evolution : nutritional and clinically satisfactory.Surgical correction, albeit late mitral valve dysplasia in this girl was the only alternative capable of preventing death. With early diagnosis and prompt surgical correction, one could avoid the associated morbidity and mortality in these cases.

Palavras-chave : Mitral regurgitation; heart failure; mitral valve replacement.

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