[Long-term results of mitral valve prosthesis in patients with severe anatomo-functional involvement of the left ventricle].
The purpose of this paper was to study the long term results (3.6 +/- 1.4 years) of 74 patients with severe mitral regurgitation (MR), with cardiomegaly and functional class (FC) III and IV, who underwent mitral valve replacement with biologic and mechanical prostheses. Seventy four patients were submitted to mitral valve replacement for treatment of severe MR. Their mean age were 43 years, 63.5% were male and 70.3% belonged to white race. The biologic prostheses were used in 71.6% of the patients. The clinical symptoms were evaluated by the New York Heart Association FC. The cardiac enlargement was evaluated by cardiothoracic ratio and the left ventricular function by echocardiogram. All patients with mechanical prostheses and with atrial fibrillation received long-term anticoagulant therapy. Before the surgery all patients received digitalis, diuretics and vasodilators. Before the surgery 66.2% of the patients were in FC III and 33.8% in FC IV; 3.6 +/- 1.4 years after the surgery 62.1% were in FC I, 27% in FC II and 10.8% in FC III. The cardiothoracic ratio decreased from 61.8 +/- 5.7% to 55.7% (p < 0.05); the diastolic diameter of the left ventricle decreased from 6.1 +/- 0.64 to 5 +/- 0.89 (p < 0.05) and the ejection fraction didn't change significantly (p > 0.05). Thromboembolism occurred in 2.7% of the patients. The mitral valve replacement produces a very good later results, relief the symptoms of the patients with severe mitral regurgitation, decrease the cardiac size and improve the left ventricular function.
Hospital Universitário Pedro Ernesto-UERJ.
J
J
Barbosa Filho
P R
PR
Barbosa
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D011446:Prospective Studies; D013997:Time Factors; D016277:Ventricular Function, Left
Resultados tardios das próteses na posição mitral em pacientes com grave comprometimento anátomo-funcional do ventrículo esquerdo.