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| Format: | Artículo científico |
| Language: | en |
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Federación Argentina de Cardiología
2008
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| Online Access: | https://www.redalyc.org/articulo.oa?id=321927783003 |
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| _version_ | 1866812775346470912 |
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| author | Enio Buffolo |
| author_facet | Enio Buffolo |
| contents | Cardiomyopathy and secondary mitral insufficiency. Surgical possibilities in the end-stage phase Enio Buffolo João Nelson R. Branco Medicina Cardiomyopathy Mitral Prosthesis Mitral Regurgitation Refractary Heart Failure Secondary Mitral Insufficiency Background. Secondary mitral insufficiency is a strong risk factor for death in end stage cardiomyopathies. The possible correction of mitral regurgitation is now been accepted as an alternative to cardiac transplantation in a special subset of patients. We proposed a surgical approach that consists of implantation of a mitral prosthesis smaller than the annulus and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. Methods. Between December 1995 and March 2008, 132 cardiomyopathies were operated on including the following etiologies: ischemic (78), idiopathic (49), Chaga’s disease (3), viral (1), and postpartum (1). The patients were analyzed according to clinical criteria, echocardiographic findings and morphology of left ventricle. Results. All patients were in an end-stage phase, requiring >2 hospital admissions over the past 3 months, despite receiving full medication. Furthermore, 8 were in intensive care unit receiving intravenous drugs or intra-aortic balloon counterpulsation, and one was in cardiogenic shock. Hospital mortality was 14.4% (19/132) yet midterm follow-up showed a relatively flat late survival curve, with evidence of improved clinical status, better echocardiographic parameters, and reduction ventricular sphericity. Conclusions. The high early mortality rate is related to other clinical conditions at the time of surgery. However, the resultant flat survival after this early interval offers a promising long-term therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy that is associated to moderate or severe secondary mitral regurgitation. 2008 artículo científico 1850-1044 https://www.redalyc.org/articulo.oa?id=321927783003 en http://www.redalyc.org/revista.oa?id=3219 INSUFICIENCIA CARDIACA application/pdf Federación Argentina de Cardiología INSUFICIENCIA CARDIACA (Argentina) Num.3 Vol.3 |
| format | Artículo científico |
| id | redalyc_321927783003 |
| language | en |
| publishDate | 2008 |
| publisher | Federación Argentina de Cardiología |
| spellingShingle | Cardiomyopathy and secondary mitral insufficiency. Surgical possibilities in the end-stage phase Enio Buffolo Medicina Cardiomyopathy Mitral Prosthesis Mitral Regurgitation Refractary Heart Failure Secondary Mitral Insufficiency Cardiomyopathy and secondary mitral insufficiency. Surgical possibilities in the end-stage phase Enio Buffolo João Nelson R. Branco Medicina Cardiomyopathy Mitral Prosthesis Mitral Regurgitation Refractary Heart Failure Secondary Mitral Insufficiency Background. Secondary mitral insufficiency is a strong risk factor for death in end stage cardiomyopathies. The possible correction of mitral regurgitation is now been accepted as an alternative to cardiac transplantation in a special subset of patients. We proposed a surgical approach that consists of implantation of a mitral prosthesis smaller than the annulus and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. Methods. Between December 1995 and March 2008, 132 cardiomyopathies were operated on including the following etiologies: ischemic (78), idiopathic (49), Chaga’s disease (3), viral (1), and postpartum (1). The patients were analyzed according to clinical criteria, echocardiographic findings and morphology of left ventricle. Results. All patients were in an end-stage phase, requiring >2 hospital admissions over the past 3 months, despite receiving full medication. Furthermore, 8 were in intensive care unit receiving intravenous drugs or intra-aortic balloon counterpulsation, and one was in cardiogenic shock. Hospital mortality was 14.4% (19/132) yet midterm follow-up showed a relatively flat late survival curve, with evidence of improved clinical status, better echocardiographic parameters, and reduction ventricular sphericity. Conclusions. The high early mortality rate is related to other clinical conditions at the time of surgery. However, the resultant flat survival after this early interval offers a promising long-term therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy that is associated to moderate or severe secondary mitral regurgitation. 2008 artículo científico 1850-1044 https://www.redalyc.org/articulo.oa?id=321927783003 en http://www.redalyc.org/revista.oa?id=3219 INSUFICIENCIA CARDIACA application/pdf Federación Argentina de Cardiología INSUFICIENCIA CARDIACA (Argentina) Num.3 Vol.3 |
| title | Cardiomyopathy and secondary mitral insufficiency. Surgical possibilities in the end-stage phase |
| topic | Medicina Cardiomyopathy Mitral Prosthesis Mitral Regurgitation Refractary Heart Failure Secondary Mitral Insufficiency |
| url | https://www.redalyc.org/articulo.oa?id=321927783003 |