title: Improvement in left ventricular dysfunction after surgical correction of mitral regurgitation.
abstract: 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.
authors.affiliation: Division of Cardiac Surgery, National Institute of Cardiology Laranjeiras, Health Ministery, Rio de Janeiro, RJ, Brazil. ascrbr@centroin.com.br
authors.forename: Antônio Sérgio Cordeiro
authors.initials: AS
authors.lastname: da Rocha
authors.forename: Nazareth de Novaes
authors.initials: Nde N
authors.lastname: da Rocha
authors.forename: Rita de Cássia Villela
authors.initials: Rde C
authors.lastname: Soares
authors.forename: Marialda
authors.initials: M
authors.lastname: Coimbra
authors.forename: Rosana Grandelle
authors.initials: RG
authors.lastname: Ramos
authors.forename: Clara
authors.initials: C
authors.lastname: Weksler
authors.forename: Fernando Eugênio
authors.initials: FE
authors.lastname: Cruz Filho
authors.forename: Celso Garcia
authors.initials: CG
authors.lastname: da Silveira
authors.forename: Paulo Roberto Dutra
authors.initials: PR
authors.lastname: da Silva
mesh_terms: 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*