miocardiopatia terminal com insuficiência mitral secundária: tratamento com implante de prótese e remodelamento interno do ventrículo esquerdo end stage cardiomyopathy and secondary mitral insufficiency: surgical alternative with prostesis implant and left ventricular remodelling

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ID: 233348
2006
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Abstract
OBJETIVO: Analisar o resultado de uma alternativa operatória que envolve a correção da regurgitação mitral pelo implante de uma prótese de diâmetro menor do que o anel mitral e redução da esfericidade do ventrículo esquerdo com tração dos músculos papilares em direção ao anel, em portadores de miocardiopatia terminal e regurgitação mitral secundária. MÉTODO: Entre dezembro de 1995 e setembro de 2005, 116 pacientes foram operados com a técnica proposta. Os pacientes foram analisados de acordo com critérios clínicos, dados ecocardiográficos e aspectos morfológicos do ventrículo esquerdo. RESULTADOS: A mortalidade hospitalar foi 16,3% (19/116). O tempo médio de acompanhamento foi 38±16 meses. Após a alta hospitalar, a curva atuarial de sobrevida permaneceu estável com aceitável taxa de mortalidade tardia. Observou-se importante melhora clínica dos pacientes e de alguns parâmetros ecocardiográficos, especialmente redução da esfericidade do ventrículo esquerdo. CONCLUSÃO: Apesar da alta mortalidade operatória, a técnica apresentada representa uma alternativa aceitável no tratamento de portadores de miocardiopatia terminal com insuficiência cardíaca refratária associada à regurgitação mitral secundária.
OBJECTIVE: To present a new surgical approach that consists of the implantation of a mitral prosthesis smaller than the annulus with traction of the papillary muscles to reduce the sphericalness of the left ventricle. METHODS: Between December 1995 and September 2005, 116 heart disease patients were operated, all of whom were at end-stage despite of full medication. The patients were analysed according to clinical criteria, echocardiographic findings and morphology of the left ventricle. RESULTS: Hospital mortality was 16.3% (19/116) and mid-term follow-up (38 ± 16 months) showed evidence of improvement in the clinical status and some echocardiographic parameters, in particular reduction of the sphericalness of the left ventricle. CONCLUSION: This technique, despite of the high mortality rate, offers a promising therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy associated to moderate or severe secondary mitral regurgitation.
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breda2006brazilianmiocardiopatia Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;João Roberto Breda;José Honório de Almeida Palma;Carlos Alberto Teles;João Nelson Rodrigues Branco;Roberto Catani;Enio Buffolo
Journal 2017 international conference on information technology systems and innovation, icitsi 2017 - proceedings
Year 2006
DOI
10.1590/S0102-76382006000300007
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382006000300007
Keywords
dilated cardiomyopathy congestive heart failure

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