ABSTRACT

Objective:

To investigate the localization, type, associations, other accompanying abnormalities and treatment methods.

Material and Methods:

The study included 24 cases presenting to the Pediatric Cardiology Unit of our Hospital with more than one left heart lesion, evaluated with two-dimensional color Doppler echocardiography (Vivid 7 Pro); 18 underwent cardiac catheterization and angiography. Complaints at admission, lesion site, type and associations, additional abnormalities and treatment were evaluated.

Results:

Multiple obstructive left heart lesions were more frequent (79%) in males, at an average age of 6.3. Most frequent symptoms at admission were dyspnea, fatigability and cyanosis. The most frequent associations of obstructive abnormalities were: mitral and aortic stenosis in 29%, mitral stenosis with aortic coarctation in 17% and aortic valve stenosis with aortic coarctation in 37%. Mitral stenosis associated to both aortic valve stenosis and aortic coarctation was seen in 17%. The most frequent associated non-obstructive abnormality was a bicuspid aortic valve (62%). Following diagnosis, 5 of the patients did not show up for follow-up, while the decision for one patient was observation. The remaining 18 cases underwent cardiac catheterization and angiography. Six patients had successful coarctation angioplasty and one angioplasty plus aortic valvuloplasty. We lost 2 of the patients who had undergone coarctation angioplasty.

Conclusion:

It was observed that the lesion most significantly contributing to mortality due to congenital obstructive lesions of left heart outflow are mitral valve obstruction and pulmonary hypertension, and that early invasive intervention is life-saving.