Mitral Valve Replacement and Remodeling of the Left Ventricle in Dilated Cardiomyopathy with Mitral Regurgitation: Initial Results
AUTOR(ES)
Puig, Luiz Boro, Gaiotto, Fábio Antonio, Oliveira Júnior, José de Lima, Pardi, Mirian Magalhães, Bacal, Fernando, Mady, Charles, Fernandes, Fábio, Bellotti, Giovanni, Ramires, José Antonio Franchini, Oliveira, Sérgio Almeida de
FONTE
Arquivos Brasileiros de Cardiologia
DATA DE PUBLICAÇÃO
2002-02
RESUMO
OBJECTIVE: This study evaluated the effects of a new method of mitral valve replacement on left ventricular (LV) remodeling and heart failure functional class. METHODS: Eight patients (6 men) with severe mitral regurgitation from end-stage dilated cardiomyopathy underwent surgery. Five patients were in functional class (FC) IV, 2 were in FC III and 1 was in FC III/IV. Age ranged from 33 to 63 years. Both the anterior and posterior leaflets of the mitral valve were divided into hemileaflets. The resultant 4 pedicles were displaced under traction toward the left atrium and anchored between the mitral annulus and an implanted valvular prosthesis. The beating heart facilitated ideal chordae tendineae positioning. RESULTS: All patients survived and were discharged from the hospital. After a mean follow-up period of 6.5 months (1-12 m), 5 patients were in FC I; 2 in FC I/II; and 1 in FC II. The preoperative ejection fraction ranged from 19% to 30% (mean: 25.7±3.4 %), and the postoperative ejection fraction ranged from 21% to 40% (mean: 31.1± 5.8%). Doppler echocardiography showed evidence of LV remodeling in 4 patients, including lateral wall changes and a tendency of the LV cavity to return to its elliptical shape. CONCLUSION: This technique of mitral valve replacement, involving new positioning of the chordae tendineae, allowed LV remodeling and improvement in FC during this brief follow-up period.
Documentos Relacionados
- Effect of mitral valve replacement on left ventricular function in mitral regurgitation.
- Treatment of delayed rupture of the left ventricle after mitral valve replacement
- Mitral valve replacement for an annular submitral aneurysm of the left ventricle.
- Rupture of posterior wall of left ventricle after mitral valve replacement.
- Early Stabilization of Traumatic Aortic Transection and Mitral Valve Regurgitation: with Extracorporeal Membrane Oxygenation