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

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dc.contributor.author Buffolo, E.
dc.contributor.author Paula, I. M. de
dc.contributor.author Aguiar, L. F.
dc.contributor.author Branco, JNR
dc.date.accessioned 2016-01-24T12:33:50Z
dc.date.available 2016-01-24T12:33:50Z
dc.date.issued 2003-05-01
dc.identifier http://dx.doi.org/10.1046/j.1540-8191.2003.02018.x
dc.identifier.citation Journal of Cardiac Surgery. Malden: Blackwell Futura Publishing, Inc, v. 18, n. 3, p. 201-205, 2003.
dc.identifier.issn 0886-0440
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/27245
dc.description.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. en
dc.format.extent 201-205
dc.language.iso eng
dc.publisher Blackwell Futura Publishing, Inc
dc.relation.ispartof Journal of Cardiac Surgery
dc.rights Acesso restrito
dc.title End-stage cardiomyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular remodeling en
dc.type Artigo
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Escola Paulista Med, Dept Cardiovasc Surg, São Paulo, Brazil
dc.description.affiliationUnifesp Escola Paulista Med, Dept Cardiovasc Surg, São Paulo, Brazil
dc.identifier.doi 10.1046/j.1540-8191.2003.02018.x
dc.description.source Web of Science
dc.identifier.wos WOS:000183098400004



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