title: [Late heart evaluation of children with rheumatic mitral regurgitation submitted to reconstructive surgery with implantation of Gregori's ring].
abstract: OBJECTIVE
  Assess late cardiological evolution of children with rheumatic mitral regurgitation (RMR) who underwent mitral valve reconstructive surgery with implantation of Gregori's ring (MVR), from 1987 to 2003.
  
  
  METHODS
  A study was conducted to analyze a series of cases of 43 children with RMR who underwent MVR with ages ranged from five to twelve years (mean age 9.7 +/- 2.2 years); 25 of the patients were females (58.1%). Patients were evaluated as per the following clinical parameters: functional class of heart failure, heart auscultation, electrocardiogram, chest X-ray and echocardiographic findings.
  
  
  RESULTS
  Forty-three patients underwent preoperative evaluation during the postoperative period, the number of patients evaluated decreased to 31 due to the fact that 6 patients had died and 6 others underwent valve replacement surgery. Follow-up was carried out for 100% of the patients. A significant reduction of heart failure functional class was observed. Mitral systolic murmur became less intense during the postoperative period. The cardiac area on chest X-ray and the presence of left ventricular overload on electrocardiogram were reduced, as well as the mitral regurgitation level on echocardiographic study. After 188 months, the survival rate was 82%, and the annual mortality rate, 0.38%. Thirty-one (72.6%) patients did not require reoperation and the annual rate of patients who required further surgery was 0.51%.
  
  
  CONCLUSIONS
  MVR is an effective procedure for treating RMR in children, resulting in a significant improvement of functional class, mitral systolic murmur and level of mitral regurgitation, as shown on Doppler echocardiogram.
authors.affiliation: Universidade Estadual de Londrina, Hospital Evangélico de Londrina, Londrina, PR. drvitor@sercomtel.com.br
authors.forename: Vitor Hugo Soares
authors.initials: VH
authors.lastname: Machado
authors.forename: Francisco
authors.initials: F
authors.lastname: Gregori Júnior
mesh_terms: D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome