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Aortic and Mitral Valve Disease and Left Ventricular Dysfunction in Children

Maher, Kevin O. MD; Tweddell, James S. MD

doi: 10.1097/PCC.0000000000000828
Organ Systems: Cardiopathophysiology and Disorders

Objectives: In this review, we will discuss aortic stenosis, aortic regurgitation, mitral regurgitation, and mitral stenosis. We will review the etiology, anatomy, pathophysiology, presentation, and treatment of aortic and mitral valve disease. Age and lesion specific treatments are outlined based on the severity of valve disease with an aim at long-term preservation of left ventricular function.

Data Source: MEDLINE and PubMed.

Conclusions: Mitral and aortic valve disease leads to unique hemodynamic burdens that can impact left ventricular function, quality of life, and longevity. The primary challenge in the management of mitral and aortic valve disease is to apply appropriate medical management and identify that point in time at which the surgery is necessary. Although guidelines have been established for the management of aortic and mitral valve disease in adults, the challenges of early presentation, maintenance of growth potential, and apparent increased tolerance of hemodynamic burden in children makes decision making challenging.

1Division of Cardiology, Department of Pediatrics, Children’s Healthcare Atlanta, Emory University School of Medicine, Atlanta, GA.

2Department of Surgery, Heart Institute, Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Dr. Maher disclosed other support (Board Member, American Heart Association [Regional Board of Directors flights and hotel costs for meetings]). His institution received funding from the Food and Drug Administration (grant) and from the Rady Children’s Hospital (payment for speaking at a conference). Dr. Tweddell disclosed that he does not have any potential conflicts of interest.

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©2016The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies