Commissurotomie mitrale percutanée et syndrome de Lutembacher

Abstract

Introduction. – Lutembacher syndrome refers to the rare combination of congenital atrial septal defect and acquired mitral stenosis. This condition is usually treated surgically by mitral valve operation with concomitant closure of the atrial septal defect. Materials and methods. – Between 1993 and 2003, 4 patients with congenital Lutembacher syndrome had percutaneous mitral commissurotomy without closure of the atrial septal defect at our institution. The 4 patients were very symptomatic with right-sided heart failure signs and NYHA functional class III-IV. Results. – The procedure was carried out successfully for the four patients. Mitral valve area increased from 0,87 to 1,97 cm 2 at mean; left atrial pressure decreased from 28,2 to 12,7 mmHg and the mean valve mitral gradient was reduced from 15,5 to 3,9 mmHg. Functional and clinical improvement was observed in all the cases. During a mean follow up of 55 ± 29 months, our 4 patients remain pauci symptomatic under medical treatment. Conclusion. – The percutaneous treatment of the Lutembacher syndrome is currently a possible alternative to the surgery among patients having an anatomy favourable to the procedure.