Improvement in left ventricular dysfunction after surgical correction of mitral regurgitation.
OBJECTIVE
To evaluate whether left ventricular end-systolic (ESD) diameters < or = 51mm in patients (pt) with severe chronic mitral regurgitation (MR) are predictors of a poor prognosis after mitral valve surgery (MVS).


METHODS
Eleven pt (aged 36 +/- 13 years) were studied in the preoperative period (pre), median of 36 days; in the early postoperative period (post1), median of 9 days; and in the late postoperative period (post2), mean of 38.5 +/- 37.6 months. Clinical and echocardiographic data were gathered from each pt with MR and systolic diameter > or = 51 mm (mean = 57 +/- 4mm) to evaluate the result of MVS. Ten patients were in NYHA Class III/IV.


RESULTS
All but 2 pt improved in functional class. Two pt died from heart failure and infectious endocarditis 14 and 11 months, respectively, after valve replacement. According to ejection fraction (EF) in post2, we identified 2 groups: group 1 (n=6), whose EF decreased in post1, but increased in post2 (p=0.01) and group 2 (n=5), whose EF decreased progressively from post1 to post2 (p=0.10). All pt with symptoms lasting < or = 48 months had improvement in EF in post2 (p=0.01).


CONCLUSIONS
ESD > or = 51 mm are not always associated with a poor prognosis after MVS in patients with MR. Symptoms lasting up to 48 months are associated with improvement in left ventricular function.
da Rocha
Antônio Sérgio Cordeiro
AS
Division of Cardiac Surgery, National Institute of Cardiology Laranjeiras, Health Ministery, Rio de Janeiro, RJ, Brazil. ascrbr@centroin.com.br
da Rocha
Nazareth de Novaes
Nde N
Soares
Rita de Cássia Villela
Rde C
Coimbra
Marialda
M
Ramos
Rosana Grandelle
RG
Weksler
Clara
C
Cruz Filho
Fernando Eugênio
FE
da Silveira
Celso Garcia
CG
da Silva
Paulo Roberto Dutra
PR
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease; D003971:Diastole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011184:Postoperative Period; D011300:Preoperative Care; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000601:surgery*