Tratamento da insuficiência cardíaca terminal através da correção da insuficiência mitral secundária e remodelação ventricular
INTRODUCTION: The survival of patients in end-stage and secondary mitral insufficiency is very poor in short periods of follow-up in spite of the progress that has been made in clinical management. The occurrence of secundary mitral regurgitation compromises survival and quality of life and recent p...
| Authors: | , , , , , , |
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| Format: | article |
| Status: | Published version |
| Publication Date: | 2001 |
| Country: | Brasil |
| Institution: | Universidade Federal de São Paulo (UNIFESP) |
| Repository: | Repositório Institucional da UNIFESP |
| Language: | Portuguese |
| OAI Identifier: | oai:repositorio.unifesp.br:11600/1229 |
| Online Access: | http://dx.doi.org/10.1590/S0102-76382001000300004 http://repositorio.unifesp.br/handle/11600/1229 |
| Access Level: | Open access |
| Keyword: | Cardiac output, low Mitral valve insufficiency Ventricular remodeling Heart valve prosthesis implatation Baixo débito cardíaco Insuficiência da valva mitral Remodelação ventricular Implante de prótese de valva |
| Summary: | INTRODUCTION: The survival of patients in end-stage and secondary mitral insufficiency is very poor in short periods of follow-up in spite of the progress that has been made in clinical management. The occurrence of secundary mitral regurgitation compromises survival and quality of life and recent papers have suggested that mitral intervention could improve functional classes. OBJECTIVE: This paper describes a techniques of valvular prostheses implantation in the left A-V annulus, to correct mitral regurgitation and remodelling the basis of the left ventricle with shortening of the longitudinal axis. MATERIAL AND METHODS: We analyze 33 patients in end-stage cardiomyopathies (15 ischemic, 13 dilated, 3 Chagas' disease, 1 puerperal, 1 viral) operated on from December 85 to September 99. The ages varied from 25 to 78 years (mean 58), 57.7% males. The period of follow-up was from 4 months until 4 years (mean 22 months). RESULTS: During hospital stay, 3 deaths (3/33) occurred and 2 others occurred after hospital discharge (2/30). In this period of follow-up 88% of patients improved 1 or 2 functional classes, the echocardiographic ejection fraction improved from 30 to 36% despite elimination of regurgitant flow and the stroke volume increased from 58 to 80 ml. CONCLUSION: Refractory cardiac insufficiency with mitral regurgitation can be palliative with valvular prosthesis implantation and remodelling of left ventricle in this period of follow-up. |
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