Surgery for endomyocardial fibrosis revisited1

Autor: Cleuza Lapa, Cláudio A Gomes, Sheila Hazin, Euclides Tenório, Carlos R. Moraes, Fernando Moraes
Rok vydání: 1999
Předmět:
Zdroj: European Journal of Cardio-Thoracic Surgery. 15:309-313
ISSN: 1873-734X
1010-7940
DOI: 10.1016/s1010-7940(99)00027-5
Popis: Objective To identify life expectancy after surgery for endomyocardial fibrosis (EMF) and the events that influence it. Methods Eighty-three patients with EMF underwent endocardial decortication and atrioventricular valve replacement or repair, between December 1977 and December 1997. There were 66 (79.6%) female and 17 (20.4%) male patients, ranging in age from 4 to 59 years (mean, 31). Thirty-seven (44.5%) had biventricular disease, 34 (41.0%) had disease of the right ventricle alone and 12 (14.5%) had EMF confined to the left ventricle. All were in functional class III or IV (New York Heart Association classification). Results Sixty-eight (81.9%) patients survived the operation and were followed up for periods ranging from 2 months to 17 years. The total follow-up time was 6290 patient/months (mean, 92 months). There were 15 late deaths, but in six, the cause was not related to the underlying disease. Four (5.8%) patients presented recurrence of the fibrosis and were reoperated on and in six (8.8%), EMF appeared in the other ventricle. Five (7.3%) patients were reoperated on to replace either a valve prosthesis or a native valve which had been preserved during the first procedure. Only 24 (45%) of the 53 surviving patients are in functional class I or II. The actuarial probability of survival at 17 years, including operative mortality, was 55%. Conclusion Surgical treatment of EMF should be considered a palliative procedure because surgery does not alter the progressive nature of the disease. However, surgical therapy is recommended for patients with EMF and heart failure as it is their only hope of survival.
Databáze: OpenAIRE
Externí odkaz: