Hostname: page-component-cc8bf7c57-xrnlw Total loading time: 0 Render date: 2024-12-11T23:05:01.887Z Has data issue: false hasContentIssue false
  • English
  • Français

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.
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Coffman, JD, Sommers, SC.Familiar pseudoxanthoma elasticum and valvular heart disease. Circulation 1959; 19:242–250.CrossRefGoogle Scholar
Scalpino, JN, Edwards, WD, Stockelberg, JM, Wooten, RS, Callahan, JA, Ginsgurg, WW.Mitral stenosis associated with valvular tophi. Mayo Clin Proc 1984; 59: 512–519.Google Scholar
Vaughton, KC, Walker, DR, Sturridge, MF.Mitral valve re placement for mitral stenosis caused by Libman-Sacks endocarditis. Brit Heart J 1979; 41: 730–733.CrossRefGoogle Scholar
Rose, AG.Mitral stenosis in Whipple's disease. Thorax 1978; 33: 500–503.CrossRefGoogle ScholarPubMed
Hammer, WJ, Roberts, WC, deLeon, AC Jr. Mitral stenosis secondary to combined massive mitral annular calcific deposits and small, hypertrophied left ventricles. Am J Med 1978; 64: 371–376.Google Scholar
Thompson, JN, Finley, SC, Lorincz, AE, Finley, WH.Absence of alpha Liduronidase activity in various tissues from two sibs affected with presumably the Hurler-Scheie compound system. Birth Defects 1975; 11: 341–346.Google Scholar
Veasy, LG, Wiedmeier, SE, Orsmond, GS, Ruttenberg, HD, Boucek, MM, Roth, SJ, Tait, VF, Thompson, JA, Daly, JA, Kaplan, EL, Hill, HR.Resurgence of acute rheumatic fever in the intermountain area of the United States. New Engl J Med 1987; 316: 421–427.CrossRefGoogle ScholarPubMed
Congeni, B, Rizzo, C, Congeni, J, Streenivasan, W.Outbreak of acute rheumatic fever in northeast Ohio. J Pediatr 1987; 111: 176–179.CrossRefGoogle ScholarPubMed
Wald, ER, Bashefsky, B, Feidt, C, Chiponis, D, Dyers, C.Acute rheumatic fever in western Pensylvannia and the tristate area. Pediatrics 1987; 80: 371–374.CrossRefGoogle Scholar
Straumann, E, Meyer, B, Misteli, M, Blumberg, A, Jenzer, HR.Aortic and mitral valve disease in patients with end stage renal failure on long-term haemodialysis. Br Heart J 1992; 67: 236–239.Google Scholar
Forman, MB, Virmani, R, Robertson, RM, Stone, WJ.Mitral annular calcification in chronic renal failure. Chest 1984; 85: 367–371.Google Scholar
Inoue, K, Owaki, T, Nakamura, T, Kitamura, F, Miyamoto, N.Clinical application of transvenous mitral commissurotomy bya new balloon catheter. J Thorac Cardiovasc Surg 1984; 87: 394–402.CrossRefGoogle Scholar
Scharf, S, Wexler, J, Longnecker, RE, Blaufox, MD.Cardiovascular disease in patients on chronic hemodialytic therapy. Prog Cardiovasc Dis 1980; 22: 343–356.CrossRefGoogle ScholarPubMed
Kramer, W, Wizemann, V., Thormann, J, Kindler, M, Mueller, K, Schiepper, M.Cardiac dysfunction in patients on maintenance hemodialysis. Contr Nephrol 1986; 52: 97–109.Google Scholar
Nixon, JV, Mitchell, JH, McPhaul, JJ, Henrich, WL.Effect of hemodialysis on left ventricular function. J Clin Invest 1983; 71: 377–384.Google Scholar
Femando, HA, Friedman, HS, Zaman, Q, Celis, A, Masih, E, Stein, R, Yap, A.Echocardiographic assessment of cardiac performance in patients on maintenance hemodialysis. Cardiovasc Med 1979; 4: 459–472.Google Scholar
Schott, CR, LeSar, JF, Kotler, MN, Parry, WR, Segal, BL.The spectrum of echocardiographic findings in chronic renal failure. Cardiovasc Med 1978; 3: 217–227.Google Scholar
Nitta, M, Takamoto, T, Yajima, T, Adachi, H, Tanaka, C, Chida, Y, Taniguchi, K, Marumo, F. Effects of hemodialysis on left ventricular performance: A Doppler echocardiographic study. J Cardiol 1989; 19: 1117–1125.Google Scholar
Papadopoulou, ZL. Chronic renal failure. In:Barakat, AY (ed). Renal Disease in Children: Clinical Evaluation and Diagnosis. Springer-Verlag,New York, 1990, pp 286–305.Google Scholar
Maher, ER, Razianas, M, Curtio, JR.Calcific aortic stenosis: a complication of uremia. Nephron 1987; 47: 119–122.CrossRefGoogle Scholar
Fulkerson, PK, Baever, BM, Auseon, JC, Graber, HL.Calcification of the mitral annulus.Ann J Med 1979; 66: 967–977.Google Scholar
Maher, ER, Young, G, Smyth-Walsh, B, Pugh, S, Curtis, JR.Aortic and mitral valve calcification in patients with end stage renal disease. Lancet 1987; 11: 875–877.CrossRefGoogle Scholar
Shone, JD, Sellers, RD, Anderson, RC, Adam, P, Lillehei, CW, Edwards, JE.The developmental complex of “parachute mitral valve,” supravalvular ring of left atrium, subaortic stenosis and coarctation of the aorta. Am J Cardiol 1963; 11: 714–724.Google Scholar
Ruckman, RN, VanPraagh, R.Anatomic types of congenital mitral stenosis: Report of49 autopsy cases with consideration ofdiagnosis and surgical implications. Am J Cardiol 1978; 42: 592–601.CrossRefGoogle Scholar
El-Said, GM, Sorour, KA. Acute rheumatic fever. In: Garson, A Jr, Bricker, JT, McNamara, DG (eds). The Science and Practice of Pediatric Cardiology. Lea & Febiger, Philadelphia, 1990, pp 1485–1501.Google Scholar
Silver, MD.. Blood flow obstruction related to tricuspid, pulmonary, and mitral valves. In: Silver, MD (ed). Cardiovascular Pathology, 2nd Edition, Volume 2. Churchill Livingstone, 1991, pp 933–960.Google Scholar
Campos Assis, RV, de Lourdes Higuchi, M.New pathological aspects of rheumatic heart disease. Cardiol Young 1992;2: 216–221.Google Scholar
El-Said, GM, El-Refaee, MM. Rheumatic heart disease. In: Garson, A Jr, Bricker, JT, McNamara, DG(eds).The Science and Practice of Pediatric Cardiology. Lea & Febiger, Philadelphia, 1990, pp 1502–1526.Google Scholar
Davies, MJ.The cardiomyopathies: a review of terminology, pathologyand pathogenesis. Hisropathology 1984; 8: 363–393.Google Scholar
Spevak, PJ, Bass, JL, Ben-Shachar, C, Hesslein, P, Keane, JF, Perry, S, Pyles, L, Lock, JE.Balloon angioplasty for congenital mitral stenosis. Am J Cardiol 1990;66: 472–476.CrossRefGoogle ScholarPubMed
Grifka, RG, O'Laughlin, MP, Nihill, MR, Mullins, CE.Doubletransseptal, double-balloon valvuloplasty for congenital mitral stenosis. Circulation 1992; 85: 123–129.Google Scholar
Allen, HD, Driscoll, DJ, Fricker, FJ, Herndon, P, Mullins, CE, Snider, AR, Taubert, KA.Guidelines for pediatric therapeutic cardiac catheterization.Circulation 1991; 85: 2248–2258.Google Scholar