[Valve replacement with chordal preservation and valvuloplasty for chronic mitral insufficiency].

Autor:	Dancini JL; Instituto do Coração, Hospital das Clínicas, FM, USP. jluiz1003@uol.com.br, Pomerantzeff PM, Spina GS, Pardi MM, Giorgi MC, Sampaio RO, Grinberg M, Oliveira SA
Jazyk:	portugalština
Zdroj:	Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2004 Mar; Vol. 82 (3), pp. 235-42. Date of Electronic Publication: 2004 Apr 05.
DOI:	10.1590/s0066-782x2004000300004
Abstrakt:	Objective: To compare, from the clinical and laboratory points of view, 3 groups of patients undergoing surgical treatment for isolated chronic mitral insufficiency. One group underwent valvuloplasty, and the other 2 groups underwent mitral valve replacement with different techniques for chordal preservation. Methods: Twenty-eight patients with a mean age of 54.1 years, no coronary or multivalvular disease, and no reoperation, underwent surgery as follows: 9 underwent valvuloplasty; 10 underwent mitral valve replacement with chordal preservation in both leaflets; and 9 underwent mitral valve replacement with chordal preservation only in the posterior leaflet. Clinical, Doppler echocardiographic, and radionuclide ventriculographic assessments were performed until the 6th month of follow-up. Results: At the end, 88.8% of the patients were in functional class I. One died due to intracranial hemorrhage during anticoagulant treatment. The left ventricular diastolic diameter (P<0.0001) and end-diastolic volume (P<0.0001) decreased in the 3 groups. Only the patients undergoing valvuloplasty had a decrease in systolic diameter (P=0.0003) and in end-systolic volume (P=0.0040), with no change in the ejection fraction (P=0.5586). The patients undergoing mitral valve replacement had a similar drop in ejection fraction (P=0.0001 and P=0.0296). Conclusion: The 3 surgical techniques used provided clinical improvement. Patients undergoing valvuloplasty had better preservation of ventricular function. No significant difference was observed in cardiac performance between the 2 groups undergoing mitral valve replacement with chordal preservation within a 6-month follow-up.
Databáze:	MEDLINE
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