Mitral valve replacement with a mechanical prosthesis can be successfully performed and managed in an infant with severe left ventricular outflow tract obstruction due to an anomalous mitral valve.
May support consideration of mechanical mitral replacement in select infants; leaves open durability and anticoagulation questions for broader use.
A four month old infant was investigated for heart failure was found to have mitral incompetence and severe subvalvar aortic stenosis. The left ventricular outflow tract obstruction was found to be due to an anatomically anomalous mitral valve. The obstruction could only be relieved by removal of the mitral valve and its replacement with a St Jude's prosthesis. Two years after operation the child is fit and active. There have been no difficulties with anticoagulant treatment.
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Morais et al. (1986) studied this question.
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