Résultats de la plastie mitrale dans la pathologie rhumatismale

Autor: Bakkali, Abderrahmane, Jaabari, Imad, Belkhadir, Aziz, Laaroussi, Mohamed
Rok vydání: 2017
Předmět:
DOI: 10.24399/jctcv21-1-bak
Popis: JCTCV:21(1)
Objective: This study aims to assess the early and long-term results of mitral valve repair in rheumatic disease. Patients and Methods: This is a retrospective study about 164 patients who underwent mitral valve repair for rheumatic mitral disease over the period from 1996 to 2005. Results: The mean age was 30.9 ± 13.8 years with female predominance. The preoperative New York Heart Association (NYHA) functional classes were III–IV in 131 cases (79.9%). Ninety-three (56.7%) were in atrial fibrillation. The mean ejection fraction was 58.5 ± 9.4%. All patients underwent mitral annuloplasty. Reparative procedures included commissurotomy (n = 121), reparation of subvalvular apparatus (n = 74) and cusp resection (n = 3). Associated procedures included tricuspid annuloplasty (n = 44), aortic valve replacement (n = 38), reduction of the left atrium (n =16) and extension of the anterior tricuspid valve with pericardium (n = 12). Early mortality was 2.4%. The reoperation rate was 2.4%. In the postoperative course, some complications were seen: transient hemolysis (n = 9), transient complete heart block (n = 2) and mediastinitis (n = 1). No case of SAM (systolic anterior motion) has been signaled. One hundred and thirty-seven patients (83.5%) have been reviewed. The median follow-up was 54 months (range 1 to 113 months). Actuarial reoperation-free rate was 89%. At 9 years the global survival was 94.1%. Ninety-seven patients (70.8%) were in NYHA functional class I, 50.3% presented a minimal mitral regurgitation, 13.1% a moderate mitral insufficiency and 19.2% presented a moderate mitral stenosis. Conclusion: Despite the evolutionary character of rheumatic lesions, mitral valve repair provides acceptable early and long-term results.
Databáze: OpenAIRE
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