Mitral valve replacement with crossed papillopexy and annular constriction in heart failure patients.
OBJECTIVE
To analyze the short-term and mid-term follow-ups of patients with heart failure and moderate to severe mitral valve insufficiency and who have undergone mitral valve replacement with crossed papillopexy and annular constriction.


METHODS
Thirteen patients in NYHA functional class III or IV, with a mean age of 54.1 years and with idiopathic etiology, underwent mitral valve replacement with ring constriction and crossed papillopexy. Echocardiograph parameters, functional class and survival actuarial curve were analyzed.


RESULTS
There were no deaths during surgery or in the postoperative period. The mean left ventricular diastolic diameter was reduced from 71 +/- 8.6 mm to 65.3 +/- 8.6 mm (p=0.049) and the mean left ventricular systolic diameter was reduced from .1 +/- 8.5 mm to 50.4 +/- 11.1 mm (p=0.002). The atrial diameters varied from 49.4 +/- 6.4 mm to 44 +/- 5.9 mm (p=0.017); the percentage of the left ventricular shortening was 17 +/- 4 % to 24 +/- 8.3% (p=0.014); the ejection fraction varied statistically and significantly from 34 +/- 9% to 45 +/- 14% (p=0.008). Eleven (84.6%) patients were in FC I and II. At 1, 6 and 12 months after follow-up surgery, the survival rate was 100%, 82.6%, 71.6%, respectively. This rate was maintained at 7.6% for more than 36 months.


CONCLUSIONS
The results obtained from patients with heart failure and moderate to severe mitral valve insufficiency and who underwent mitral valve replacement with crossed papillopexy and annular constriction presented evidence of improved heart remodeling and significant improvement in left ventricular performance.
Benfatti
Ricardo Adala
RA
Cardiothoracic Surgery, UFMS. ricardobenfatti@gmail.com
Pontes
José Carlos Dorsa Vieira
JC
Gomes
Otoni Moreira
OM
Dias
Amaury Edgardo Mont'serrat Avila Souza
AE
Gomes Júnior
Jandir Ferreira
JF
Gardenal
Neimar
N
Duarte
João Jackson
JJ
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D010210:Papillary Muscles / Q000601:surgery*; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology