Miocardiopatia terminal com insuficiência mitral secundária: tratamento com implante de prótese e remodelamento interno do ventrículo esquerdo

• Autor(a) principal: Breda, João Roberto [UNIFESP]
• Data de Publicação: 2006
• Outros Autores: Fonseca, José Honório de Almeida Palma da [UNIFESP], Teles, Carlos Alberto [UNIFESP], Branco, João Nelson Rodrigues [UNIFESP], Catani, Roberto [UNIFESP], Buffolo, Enio [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0102-76382006000300007; http://repositorio.unifesp.br/handle/11600/3224
• topic: Congestive heart failure; Dilated cardiomyopathy; Mitral valve insufficiency; Insuficiência cardíaca congestiva; Cardiomiopatia dilatada; Insuficiência da valva mitral

OBJECTIVE: To present a new surgical approach that consists of the implantation of a mitral prosthesis smaller than the annulus with traction of the papillary muscles to reduce the sphericalness of the left ventricle. METHODS: Between December 1995 and September 2005, 116 heart disease patients were operated, all of whom were at end-stage despite of full medication. The patients were analysed according to clinical criteria, echocardiographic findings and morphology of the left ventricle. RESULTS: Hospital mortality was 16.3% (19/116) and mid-term follow-up (38 ± 16 months) showed evidence of improvement in the clinical status and some echocardiographic parameters, in particular reduction of the sphericalness of the left ventricle. CONCLUSION: This technique, despite of the high mortality rate, offers a promising therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy associated to moderate or severe secondary mitral regurgitation.