End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/28796 http://dx.doi.org/10.1016/j.ejcts.2006.03.004 |
Resumo: | Background: Secondary mitral insufficiency is a strong risk factor for death in end-stage cardiomyopathy. the possible correction of mitral regurgitation has now been accepted as an alternative to cardiac transplantation in a special subset of patients. We propose a new surgical approach that consists of implantation of a mitral prosthesis that is smaller than the annulus, and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. Methods: Between December 1995 and September 2005, 116 patients with dilated cardiomyopathy underwent this procedure, with the following etiologic factors: ischemic (68), idiopathic (43), Chagas disease (3), viral (1), and postpartum (1). the patients were analyzed according to clinical criteria, echocardiographic findings, and morphology of left ventricle. Results: All patients were in an end-stage phase, requiring > 2 hospital admissions over the past 3 months, despite receiving full medication. Furthermore, seven were in intensive care unit receiving intravenous drugs or intra-aortic balloon counterpulsation, and one was in cardiogenic shock. Hospital mortality was 16.3% (19/116), yet midterm follow-up showed a relatively flat late survival curve, with evidence of improved clinical status, better echocardiographic parameters, and reduction in ventricular sphericity. Conclusions: the high early mortality rate related to other clinical conditions at the time of surgery. However, the resultant flat survival after this early interval offers a promising long-term therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy that is associated with moderate or severe secondary mitral regurgitation. (c) 2006 Elsevier B.V. All rights reserved. |
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Buffolo, Enio [UNIFESP]Branco, João Nelson R [UNIFESP]Catani, Roberto [UNIFESP]RESTORE GrpUniversidade Federal de São Paulo (UNIFESP)2016-01-24T12:41:02Z2016-01-24T12:41:02Z2006-04-01European Journal of Cardio-thoracic Surgery. Amsterdam: Elsevier B.V., v. 29, p. S266-S271, 2006.1010-7940http://repositorio.unifesp.br/handle/11600/28796http://dx.doi.org/10.1016/j.ejcts.2006.03.00410.1016/j.ejcts.2006.03.004WOS:000237923300033Background: Secondary mitral insufficiency is a strong risk factor for death in end-stage cardiomyopathy. the possible correction of mitral regurgitation has now been accepted as an alternative to cardiac transplantation in a special subset of patients. We propose a new surgical approach that consists of implantation of a mitral prosthesis that is smaller than the annulus, and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. Methods: Between December 1995 and September 2005, 116 patients with dilated cardiomyopathy underwent this procedure, with the following etiologic factors: ischemic (68), idiopathic (43), Chagas disease (3), viral (1), and postpartum (1). the patients were analyzed according to clinical criteria, echocardiographic findings, and morphology of left ventricle. Results: All patients were in an end-stage phase, requiring > 2 hospital admissions over the past 3 months, despite receiving full medication. Furthermore, seven were in intensive care unit receiving intravenous drugs or intra-aortic balloon counterpulsation, and one was in cardiogenic shock. Hospital mortality was 16.3% (19/116), yet midterm follow-up showed a relatively flat late survival curve, with evidence of improved clinical status, better echocardiographic parameters, and reduction in ventricular sphericity. Conclusions: the high early mortality rate related to other clinical conditions at the time of surgery. However, the resultant flat survival after this early interval offers a promising long-term therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy that is associated with moderate or severe secondary mitral regurgitation. (c) 2006 Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Paulista Sch Med, Dept Cardiovasc Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Cardiovasc Surg, São Paulo, BrazilWeb of ScienceS266-S271engElsevier B.V.European Journal of Cardio-thoracic Surgeryhttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policyinfo:eu-repo/semantics/openAccessheart failureend-stage cardiomyopathymitral insufficiencyleft ventricular restorationEnd-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restorationinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlereponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/287962022-09-27 11:18:58.884metadata only accessoai:repositorio.unifesp.br:11600/28796Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:25:26.479781Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
title |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
spellingShingle |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration Buffolo, Enio [UNIFESP] heart failure end-stage cardiomyopathy mitral insufficiency left ventricular restoration |
title_short |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
title_full |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
title_fullStr |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
title_full_unstemmed |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
title_sort |
End-stage cardiornyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration |
author |
Buffolo, Enio [UNIFESP] |
author_facet |
Buffolo, Enio [UNIFESP] Branco, João Nelson R [UNIFESP] Catani, Roberto [UNIFESP] RESTORE Grp |
author_role |
author |
author2 |
Branco, João Nelson R [UNIFESP] Catani, Roberto [UNIFESP] RESTORE Grp |
author2_role |
author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Buffolo, Enio [UNIFESP] Branco, João Nelson R [UNIFESP] Catani, Roberto [UNIFESP] RESTORE Grp |
dc.subject.eng.fl_str_mv |
heart failure end-stage cardiomyopathy mitral insufficiency left ventricular restoration |
topic |
heart failure end-stage cardiomyopathy mitral insufficiency left ventricular restoration |
description |
Background: Secondary mitral insufficiency is a strong risk factor for death in end-stage cardiomyopathy. the possible correction of mitral regurgitation has now been accepted as an alternative to cardiac transplantation in a special subset of patients. We propose a new surgical approach that consists of implantation of a mitral prosthesis that is smaller than the annulus, and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. Methods: Between December 1995 and September 2005, 116 patients with dilated cardiomyopathy underwent this procedure, with the following etiologic factors: ischemic (68), idiopathic (43), Chagas disease (3), viral (1), and postpartum (1). the patients were analyzed according to clinical criteria, echocardiographic findings, and morphology of left ventricle. Results: All patients were in an end-stage phase, requiring > 2 hospital admissions over the past 3 months, despite receiving full medication. Furthermore, seven were in intensive care unit receiving intravenous drugs or intra-aortic balloon counterpulsation, and one was in cardiogenic shock. Hospital mortality was 16.3% (19/116), yet midterm follow-up showed a relatively flat late survival curve, with evidence of improved clinical status, better echocardiographic parameters, and reduction in ventricular sphericity. Conclusions: the high early mortality rate related to other clinical conditions at the time of surgery. However, the resultant flat survival after this early interval offers a promising long-term therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy that is associated with moderate or severe secondary mitral regurgitation. (c) 2006 Elsevier B.V. All rights reserved. |
publishDate |
2006 |
dc.date.issued.fl_str_mv |
2006-04-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T12:41:02Z |
dc.date.available.fl_str_mv |
2016-01-24T12:41:02Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
European Journal of Cardio-thoracic Surgery. Amsterdam: Elsevier B.V., v. 29, p. S266-S271, 2006. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/28796 http://dx.doi.org/10.1016/j.ejcts.2006.03.004 |
dc.identifier.issn.none.fl_str_mv |
1010-7940 |
dc.identifier.doi.none.fl_str_mv |
10.1016/j.ejcts.2006.03.004 |
dc.identifier.wos.none.fl_str_mv |
WOS:000237923300033 |
identifier_str_mv |
European Journal of Cardio-thoracic Surgery. Amsterdam: Elsevier B.V., v. 29, p. S266-S271, 2006. 1010-7940 10.1016/j.ejcts.2006.03.004 WOS:000237923300033 |
url |
http://repositorio.unifesp.br/handle/11600/28796 http://dx.doi.org/10.1016/j.ejcts.2006.03.004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
European Journal of Cardio-thoracic Surgery |
dc.rights.driver.fl_str_mv |
http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
S266-S271 |
dc.publisher.none.fl_str_mv |
Elsevier B.V. |
publisher.none.fl_str_mv |
Elsevier B.V. |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1783460288804159488 |