End-stage cardiomyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular remodeling

End-stage cardiomyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular remodeling

Author Buffolo, E. Google Scholar
Paula, I. M. de Google Scholar
Aguiar, L. F. Google Scholar
Branco, JNR Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Secondary mitral insufficiency is a strong risk factor for death in end-stage cardiomyopathies. the possible correction of mitral regurgitation is now being accepted as an alternative to cardiac transplantation in a special subset of patients. We proposed a new surgical approach that consisted of implantation of a mitral prosthesis smaller than the annulus, as well as preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. Between December 1995 and August 2001, 71 cases were operated on including the following etiologies: ischemic (38), idiopathic (29), Chaga's disease (2), viral (1), and postpartum (1). All patients were in an end-stage phase with more than two hospital admissions in the last three months; seven were in intensive care units receiving drugs and intra-aortic balloon counterpulsation, and one was in cardiogenic shock. the patients were analyzed according to clinical criteria, echocardiographic findings, and morphology of the left ventricle. Hospital mortality was 16.9% (12/71) and mid-term follow-up showed evidence of improvement in clinical status and some echocardiographic parameters. This technique, despite a high mortality rate (due to other clinical conditions at the time of surgery), offers a promising therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy associated with secondary mitral regurgitation.
Language English
Date 2003-05-01
Published in Journal of Cardiac Surgery. Malden: Blackwell Futura Publishing, Inc, v. 18, n. 3, p. 201-205, 2003.
ISSN 0886-0440 (Sherpa/Romeo, impact factor)
Publisher Blackwell Futura Publishing, Inc
Extent 201-205
Origin http://dx.doi.org/10.1046/j.1540-8191.2003.02018.x
Access rights Closed access
Type Article
Web of Science ID WOS:000183098400004
URI http://repositorio.unifesp.br/handle/11600/27245

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