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Mitral valvar stenosis in children maintained on hemodialysis for chronic renal failure-clinical significance and an attempt at percutaneous balloon mitral valvoplasty

Published online by Cambridge University Press:  19 August 2008

Makoto Nakazawa ,
Yumiko Takeda ,
Gengi Satomi ,
Yasutoshi Matsumoto ,
Hiroshi Kawaguchi ,
Kazuo Momma ,
Katsumi Ito  and
Masahiko Ando
Makoto Nakazawa*
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Yumiko Takeda
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Gengi Satomi
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Yasutoshi Matsumoto
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Hiroshi Kawaguchi
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Kazuo Momma
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Katsumi Ito
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
Masahiko Ando
Affiliation:
From the Departments of Pediatric Cardiology and Pediatric Nephrology, Tokyo Women's Medical College, Tokyo
*
Dr. Makoto Nakazawa, Department of Pediatric Cardiology, The Heart Institute of Japan, Tokyo Women's Medical College, 8–1 Kawadacho,Shinjuku-ku, Tokyo 162, Japan. Tel. 03-3353-8111, Ext 23110; Fax. 03-5296-7434.
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Abstract

We describe three children with chronic renal failure who developed mitral obstructive disease over a period when maintained on hemodialysis. The development and progression of the mitral disease was documented by cardiac catheterization in one child and by Doppler echocardiography in the other two children. These three patients had the lowest body weight among the 16 children undergoing chronic dialysis who were examined cardiologically in our hospital. Autopsy in one child who died from heart failure revealed marked thickening of the leaflets and subvalvar apparatus of the mitral valve with severe obliteration of the intercordal spaces. We found no sign of calcification at the mitral annulus nor at the attachments of the leaflets of the aortic valve, and no Ashoff bodies. We attempted percutaneous catheter balloon valvoplasty in one child which permitted successful renal transplantation after failure of an initial transplantation because of severe pulmonary venous congestion. We conclude that mitral obstructive disease could be a complication of long-term hemodialysis for chronic renal failure. Catheter intervention may serve to release the obstruction, although the procedure is not curative.

Keywords

Cardiac complicationspulmonary congestionInoue ballooncatheter interventionmitral valverenal failurehemodialysis
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 1 , January 1994 , pp. 55 - 61
Copyright
Copyright © Cambridge University Press 1994

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