Paraşüt mitral kapak: Morfoloji ve cerrahi tedavi

Amaç: Bu derlemede paraşüt mitral kapak morfolojisi ve cerrahi tedavisi tartışıldı. Çalışma planı: Ocak 2000 - Aralık 2018 tarihleri arasında spesifik MeSH terimleri ve anahtar sözcükleri kullanılarak PubMed, HighWire Press ve Cochrane Kütüphanesi veri tabanlarından İngilizce dilinde 330 paraşüt mitral kapak hastasını kapsayan 62 makaleye ulaşıldı. Bu çalışmalarda paraşüt mitral kapak morfolojisi ve cerrahi tedavi seçenekleri araştırıldı. Bulgular: Hastaların 287’sinde (%87.0) sendromik olmayan paraşüt mitral kapak ve 43’ünde (%13.0) sendromik paraşüt mitral kapak mevcuttu. Sendromik olanlara kıyasla, sendromik olmayan paraşüt mitral kapaklı daha fazla sayıda hasta konjestif kalp yetmezliği ile başvurdu. Sendromik olmayan paraşüt mitral kapaklı hastalarda sıklıkla mitral yetmezlik varken, sendromik paraşüt mitral kapaklı hastalarda sıklıkla mitral darlık vardı. Sonuç: Paraşüt mitral kapaklar genellikle izole bir lezyon değildir ve sıklıkla mitral kapak yaprakçıkları, anülüs, komissürler, subvalvüler aparat ve supravalvüler mitral halkanın patolojik değişikliklerinin birlikteliği ile karakterizedir. Bu nedenle, hastaların birçoğu bir veya daha fazla cerrahi işleme ihtiyaç duyar. Bu hastalarda yeniden girişim, ameliyat sonrası tam kalp bloku ve mortalite gibi advers olayların insidansı yüksektir.

Parachute mitral valve: Morphology and surgical management

Background: This review aims to discuss morphology andsurgical management of parachute mitral valve.Methods: A total of 62 articles in the English language with 330parachute mitral valve patients were retrieved from the PubMed,HighWire Press, and Cochrane Library databases using specificMeSH terms and keywords between January 2000 and December2018. In these articles, morphology of parachute mitral valve andsurgical treatment options were investigated.Results: A non-syndromic parachute mitral valve was presentin 287 patients (87.0%) and a syndromic parachute mitral valvewas present in 43 patients (13.0%). A higher number of patientswith a non-syndromic parachute mitral valve presented withcongestive heart failure compared to syndromic ones. Thepatients with a non-syndromic parachute mitral valve often hadmitral regurgitation, while syndromic parachute mitral valvepatients often had mitral stenosis.Conclusion: Parachute m itral v alves a re u sually n ot a nisolated lesion and are often characterized by a constellationof pathological changes of the mitral valve leaflets, annulus,commissures, subvalvular apparatus, and supravalvular mitralring. Therefore, the majority of the patients need one or moresurgical operations. The incidence of adverse events such asreintervention, postoperative complete heart block, and mortalityis high in these patients.

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1. Shone JD, Sellers RD, Anderson RC, Adams P Jr, Lillehei CW, Edwards JE. The developmental complex of “parachute mitral valve,” supravalvular ring of left atrium, subaortic stenosis, and coarctation of aorta. Am J Cardiol 1963;11:714-25.
2. Bett JH, Stovin PG. Parachute deformity of the mitral valve. Thorax 1969;24:632-6.
3. Brown JW, Ruzmetov M, Vijay P, Hoyer MH, Girod D, Rodefeld MD, et al. Operative results and outcomes in children with Shone’s anomaly. Ann Thorac Surg 2005;79:1358-65.
4. Séguéla PE, Houyel L, Acar P. Congenital malformations of the mitral valve. Arch Cardiovasc Dis 2011;104:465-79.
5. Turkoz R, Ayabakan C, Vuran C, Omay O, Yildirim SV, Tokel NK. Duplicate mitral valve in an infant with Shone’s anomaly. Ann Thorac Surg 2009;88:1683-5.
6. McElhinney DB, Sherwood MC, Keane JF, del Nido PJ, Almond CS, Lock JE. Current management of severe congenital mitral stenosis: outcomes of transcatheter and surgical therapy in 108 infants and children. Circulation 2005;112:707-14.
7. Aslam S, Khairy P, Shohoudi A, Mercier LA, Dore A, Marcotte F, et al. Shone complex: an under-recognized congenital heart disease with substantial morbidity in adulthood. Can J Cardiol 2017;33:253-9.
8. Carey LS, Sellers RD, Shone JD. Radiologic findings in the developmental complex of parachute mitral valve, supravalvular ring of left atrium, subaortic stenosis, and coarctation of aorta. Radiology 1964;82:1-10.
9. Schaverien MV, Freedom RM, McCrindle BW. Independent factors associated with outcomes of parachute mitral valve in 84 patients. Circulation 2004;109:2309-13.
10. Abelson M. Parachute mitral valve and a large ventricular septal defect in an asymptomatic adult. Cardiovasc J S Afr 2001;12:212-4.
11. Agnoletti G, Raisky O, Boudjemline Y, Ou P, Bonnet D, Sidi D, et al. Neonatal surgical aortic commissurotomy: predictors of outcome and long-term results. Ann Thorac Surg 2006;82:1585-92.
12. Akgüllü C, Erdoğan E. Adult patient with Shone’s syndrome and patent ductus arteriosus: a case report. Turk Kardiyol Dern Ars 2012;40:350-3.
13. Almeida S, Cotrim C, Miranda R, Lopes L, Almeida AR, Loureiro MJ, et al. The role of echocardiography in assessing parachute mitral valve. Rev Port Cardiol 2009;28:335-9.
14. Bobylev D, Meschenmoser L, Boethig D, Horke A. Surgical repair of Shone’s complex with anomalous origin of the left coronary artery arising from the right pulmonary artery. Interact Cardiovasc Thorac Surg 2015;20:439-42.
15. Chandra S, Kharwar RB, Mundhekar A. Shone complex. J Cardiovasc Ultrasound 2015;23:54-5.
16. Cho S, Kim WH, Kwak JG, Lee JR, Kim YJ. Surgical results of mitral valve repair for congenital mitral valve stenosis in paediatric patients. Interact Cardiovasc Thorac Surg 2017;25:877-82.
17. Delmo Walter EM, Hetzer R. Repair for congenital mitral valve stenosis. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2018:46-57.
18. Demirkol S, Baysan O, Celik T, Kurt IH, Kucuk U, Balta S. Incremental value of three-dimensional transesophageal echocardiography in a patient with parachute mitral valve. Echocardiography 2012;29:E24-5.
19. Demirkol S, Arslan Z, Balta S, Küçük U. A parachute mitral valve accompanying persistent left superior vena cava: assessment by three-dimensional transthoracic echocardiography. Anadolu Kardiyol Derg 2012;12:E23-4.
20. Dibardino DJ, Fraser CD Jr, Dickerson HA, Heinle JS, McKenzie ED, Kung G. Left ventricular inflow obstruction associated with persistent left superior vena cava and dilated coronary sinus. J Thorac Cardiovasc Surg 2004;127:959-62.
21. Ekici B, Erkan AF, Sökmen Y, Tüfekçioğlu O. Shone’s complex with dextrocardia and situs inversus totalis: a case report. Turk Kardiyol Dern Ars 2012;40:612-4.
22. Espinola-Zavaleta N, Chugh R, Ramírez GM. Parachute mitral valve with severe mitral regurgitation in an adult patient. Echocardiography 2012;29:E122-5.
23. Fisher D, Dipietro A, Murdison KA, Lemieux CA. Full monosomy 21: echocardiographic findings in the third molecularly confirmed case. Pediatr Cardiol 2013;34:733-5.
24. Gokhroo RK, Bisht DS, Padmanabhan D, Gupta S. Association of large muscular ventricular septal defect with parachute mitral valve: A rare case report. Indian J Cardiol 2013;16:64-6.
25. Gori T, Salerno D, Donati G. ‘Parachute’ accessory mitral leaflet and pulmonary valve stenosis in an asymptomatic 85-year-old man. Eur Heart J 2008;29:223.
26. Grimaldi A, Vermi AC, Maisano F, Sacco F, Castiglioni A, Zangrillo A, et al. Echocardiographic patterns of incomplete Shone’s syndrome in adults. J Heart Valve Dis 2011;20:552-6.
27. Henaine R, Nloga J, Wautot F, Yoshimura N, Rabilloud M, Obadia JF, et al. Long-term outcome after annular mechanical mitral valve replacement in children aged less than five years. Ann Thorac Surg 2010;90:1570-6.
28. Hosseinpour AR, Amanullah M, Ramnarine IR, Stümper O, Barron DJ, Brawn WJ. Combined atrial arterial switch operation (double switch) for hearts with Shone syndrome and pulmonary hypertension. J Thorac Cardiovasc Surg 2006;131:471-3.
29. Isılak Z, Deveci OS, Yalcın M, Uz O, Dogan M, Uzun M. A unique case of parachute mitral valve in an adult: an abnormally long chorda tendinea. Echocardiography 2012;29:E245-6.
30. Jain D, Martel M, Reyes-Múgica M, Parkash V. Heterotopic nephrogenic rests in the colon and multiple congenital anomalies: possibly related association. Pediatr Dev Pathol 2002;5:587-91.
31. Jiang ZY, Pircova A, Sekarski N, Hack I, Laurini R, Janzer R, et al. Transposition of the great arteries, pulmonary atresia, and multiple ventricular septal defects associated with multiple cardiac rhabdomyomas in a case of tuberous sclerosis. Pediatr Cardiol 2000;21:165-9.
32. Kim WH, Lee TY, Kim SC, Kim SJ, Lee YT. Unbalanced atrioventricular septal defect with parachute valve. Ann Thorac Surg 2000;70:1711-2.
33. Kurtul A, Duran M, Akkaya E, Ornek E. Parachute mitral and tricuspid valves together with ventricular septal defect. Turk Kardiyol Dern Ars 2013;41:264.
34. López-Pardo F, Urbano-Moral JA, González-Calle A, Laviana-Martinez F, Esteve-Ruiz I, Lagos-Degrande O, et al. Three-Dimensional Transesophageal Echocardiography in the Anatomical Assessment of Isolated Parachute Mitral Valve in an Adult Patient. Echocardiography 2015;32:1732-5.
35. Lorenzo N, Claver E, Alió J, Aguilar R. Incomplete Shone’s complex in the sixth decade of life: echo and cardiac magnetic resonance imaging assessment. Eur Heart J 2017;38:459.
36. Lu M, Tang H. 3166: Echocardiographic in the diagnosis of parachute mitral valve. Ultrasound Med Biol 2006;32:P219.
37. Ma XJ, Huang GY, Liang XC, Liu XQ, Jia B. Atypical Shone’s complex diagnosed by echocardiography. Pediatr Cardiol 2011;32:442-8.
38. Mądry W, Karolczak MA, Grabowski K. Supravalvar mitral ring with a parachute mitral valve and subcoarctation of the aorta in a child with hemodynamically significant VSD. A study of the morphology, echocardiographic diagnostics and surgical therapy. J Ultrason 2017;17:206-11.
39. Marino BS, Kruge LE, Cho CJ, Tomlinson RS, Shera D, Weinberg PM, et al. Parachute mitral valve: morphologic descriptors, associated lesions, and outcomes after biventricular repair. J Thorac Cardiovasc Surg 2009;137:385-93.e4.
40. Meenakshi K, Chidambaram S, Dhandapani VE, Rameshwar R. A rare association of parachute mitral valve with double outlet right ventricle and severe pulmonary hypertension in an adult. J Assoc Physicians India 2014;62:50-2.
41. Mohan JC, Shukla M, Mohan V, Sethi A. Parachute mitral valve and Pacman deformity of the ventricular septum in a middle-aged male. Indian Heart J 2016;68:S126-S30.
42. Mohan JC, Shukla M, Sethi A. Parachute deformity of both atrioventricular valves with congenitally corrected transposition in an adult. Indian Heart J 2015;67:565-9.
43. Motoda H, Murata M, Iwanaga S, Matsushita K, Nakamizo H, Wakino S, et al. Parachute mitral valve incidentally diagnosed in an adult patient with hypertension. J Echocardiogr 2010;8:28-9.
44. Myers PO, del Nido PJ, Bautista-Hernandez V, Marx GR, Emani SM, Pigula FA, et al. Biventricular repair for common atrioventricular canal defect with parachute left atrioventricular valve. Eur J Cardiothorac Surg 2016;49:546-51.
45. Nikolic A, Joksimovic Z, Jovovic L. Exuberant accessory mitral valve tissue with possible true parachute mitral valve: a case report. J Med Case Rep 2012;6:292.
46. Nkoke C, Lekoubou A, Yonta EW, Dzudie A, Kengne AP. Shone’s anomaly: a report of one case in sub-Saharan Africa. Cardiovasc Diagn Ther 2014;4:495-8.
47. Park SJ, Kwak CH, Hwang JY. Long-term survival in double inlet left ventricle combined with pulmonary stenosis and parachute mitral valve: a rare case. Int Heart J 2007;48:261-7.
48. Patsouras D, Korantzopoulos P, Kountouris E, Siogas K. Isolated parachute mitral valve as an incidental finding in an asymptomatic hypertensive adult. Clin Res Cardiol 2007;96:38-41.
49. Popescu BA, Jurcut R, Serban M, Parascan L, Ginghina C. Shone’s syndrome diagnosed with echocardiography and confirmed at pathology. Eur J Echocardiogr 2008;9:865-7.
50. Prunier F, Furber AP, Laporte J, Geslin P. Discovery of a parachute mitral valve complex (Shone’s anomaly) in an adult. Echocardiography 2001;18:179-82.
51. Purvis J, Sharma D. Adult parachute mitral valve detected in pregnancy. Heart 2011;97:1192.
52. Purvis JA, Smyth S, Barr SH. Multi-modality imaging of an adult parachute mitral valve. J Am Soc Echocardiogr 2011;24:351.e1-3.
53. Rybicka J, Dobrowolski P, Kuśmierczyk M, Rózański J, Kowalski M, Hoffman P. Parachute mitral valve in a young adult with recurrent pulmonary oedema. Acta Cardiol. 2011;66:401-3.
54. Sadeghian H, Savand-Roomi Z. Parachute mitral valve. In: Sadeghian H, Savand-Roomi Z, editors. Echocardiographic Atlas of Adult Congenital Heart Disease. Cham: Springer; 2015. p. 349-50.
55. Saroli T, Gelehrter S, Gomez-Fifer CA, van der Velde ME, Bove EL, Ensing GJ. Anomalies of left coronary artery origin affecting surgical repair of hypoplastic left heart syndrome and Shone complex. Echocardiography 2008;25:727-31.
56. Saura D, Campos JV, Villegas M, Picó F, de la Morena G, Valdés-Chávarri M. Heart-hand syndrome. Int J Cardiol 2008;129:e7-9.
57. Sethi R, Kharwar RB, Sharma A, Kumar V, Narain VS. Multimodality imaging of holmes heart with parachute mitral valve. Echocardiography 2014;31:E132-5.
58. Sharma V, Burkhart HM, Schaff HV, Cetta F, Cabalka A, Dearani JA. Management of zone of apposition in parachute left atrioventricular valve in atrioventricular septal defect. Ann Thorac Surg 2013;95:1665-9.
59. Shehatha JS, Taha AY, Mirza AJ. Late Shone complex: A case report and literature review. J Egypt Soc Cardio-Thorac Surg 2018;26:133-5
60. Stellin G, Padalino MA, Vida VL, Boccuzzo G, Orrù E, Biffanti R, et al. Surgical repair of congenital mitral valve malformations in infancy and childhood: a single-center 36-year experience. J Thorac Cardiovasc Surg 2010;140:1238-44.
61. Takawira FF, Sinyangwe G, Mwangi MN, Mathivha TM. Case report and images in cardiology: Shone’s complex variant associated with a patent ductus arteriosus: simultaneous treatment of coarctation and patent ductus arteriosus using a covered stent. SAHeart 2010;7:282-6.
62. Vistarini N, Belaidi M, Desjardins G, Pellerin M. Parachute Mitral Valve. Can J Cardiol 2016;32:1261.e5-6.
63. Vivas MF, Politi MT, Riznyk LM, Castro MF, Avegliano G, Ronderos R. Shone’s syndrome: Insights from three-dimensional echocardiography. Echocardiography 2018;35:417-9.
64. Wagner F, Gebauer RA, Paech C. Newborn in cardiogenic shock. Heart 2018;104:467.
65. Yamamoto T, Onishi T, Omar AM, Norisada K, Tatsumi K, Matsumoto K, et al. Isolated true parachute mitral valve in an asymptomatic elderly patient. J Echocardiogr 2010;8:131-2.
66. Zucker N, Levitas A, Zalzstein E. Prenatal diagnosis of Shone’s syndrome: parental counseling and clinical outcome. Ultrasound Obstet Gynecol 2004;24:629-32.
67. Chauvaud S. Surgery of congenital mitral valve disease. J Cardiovasc Surg (Torino) 2004;45:465-76.
68. Remenyi B, Gentles TL. Congenital mitral valve lesions: correlation between morphology and imaging. Ann Pediatr Cardiol 2012;5:3-12.
69. Serraf A, Piot JD, Bonnet N, Lacour-Gayet F, Touchot A, Bruniaux J, et al. Biventricular repair approach in ductodependent neonates with hypoplastic but morphologically normal left ventricle. J Am Coll Cardiol 1999;33:827-34.
70. Zias EA, Mavroudis C, Backer CL, Kohr LM, Gotteiner NL, Rocchini AP. Surgical repair of the congenitally malformed mitral valve in infants and children. Ann Thorac Surg 1998;66:1551-9.
71. Jaquiss RD. Excellent Early; Not-So-Excellent Late. Semin Thorac Cardiovasc Surg 2016;28:461-2.