Seguimento a longo prazo de pacientes submetidos à revascularização do miocárdio com uso exclusivo de enxertos arteriaisLong-term follow-up of patients undergone coronary artery bypass grafting with exclusive use of arterial grafts Abstract Objective: To evaluate the long-term results of coronary artery bypass grafting with the exclusive use of arterial grafts for patients with triple vessel disease.Methods: We evaluated 136 patients who underwent isolated coronary artery bypass grafting between January 1995 and December 1997. A total of 353 grafts were used for revascularization of 449 arteries (mean: 3.30 per patient). Grafts used were the left internal thoracic artery (99.2%), right internal thoracic artery (56.6%), radial artery (87.5%), right gastroepiploic artery (20.5%) and one inferior epigastric artery. Seventy-six (55.8%) patients received composite grafts ("Y-shape") and 66 (48.5%) patients received sequential anastomoses.Results: Hospital mortality was 4.4%. In the long-term follow-up (9.5 to 12.8 years), 82.1% of the patients were free of cardiac events. Twenty (17.9%) patients had hospital readmission due to cardiac events: 15 presented angina and five presented acute myocardial infarction, with three of them presenting with associated heart failure. Eight (7.1%) patients needed coronary re-interventions: one underwent coronary bypass reoperation and the others underwent coronary angioplasty with stent implantation. Estimated probability of being event-free was 98.2%, 95.4% and 84.2% at 1, 5 and 10 years of follow-up respectively. There were 16 (14.2%) late deaths with four of them (3.6%) being cardiacrelated. Actuarial 12.8-year survival of all types of death was 85% in this group.Conclusion: Coronary artery bypass grafting with the exclusive use of arterial grafts is a safe procedure for patients with triple vessel coronary disease with good long-term results.Descriptors: Myocardial revascularization. Arteriosclerosis/ surgery. Mammary arteries. Radial artery. ResumoObjetivo: Avaliar os resultados a longo prazo da cirurgia de revascularização do miocárdio com o uso exclusivo de enxertos arteriais em pacientes com doença coronariana triarterial.

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The aim of this study was to analyze mitral annulus (MA) dynamics using cardiac magnetic resonance (CMR) in patients with degenerative mitral insufficiency who underwent mitral valve repair (MVR). METHODS: Mitral valve imaging was performed by CMR in twenty-nine patients with degenerative mitral insufficiency who underwent MVR between July 2014 and August 2016, with quadrangular resection of the posterior leaflet without ring annuloplasty. They were prospectively followed up from the preoperative period up to 2 years postoperatively. RESULTS: We observed a significant reduction in all measurements of the MA after surgery. The mean systolic circumference of the MA was reduced from 13.28 ± 1.95 cm to 11.50 ± 1.59 cm, and the diastolic circumference was reduced from 12.51 ± 2.01 cm to 10.66 ± 2.09 cm in the immediate postoperative period, measures that remained stable 2 years after MVR (po0.001). The mean maximum area of the MA was significantly reduced from 14.34±4.03 to 10.45±3.17 cm 2 when comparing the immediate postoperative period and the 2 year follow-up (po0.001). The same occurred with the mean minimum area of the MA, which was reduced from 12.53 ± 3.68 cm 2 to 9.23 ± 2.84 cm 2 in the same period, and this reduction was greater in the antero-posterior diameter than in the mid-lateral diameter. The mobility of the MA was preserved after surgery, ranging between 19.6% and 25.7% at 2-year follow-up. CONCLUSION: We observed a significant reduction in the MA size after MVR, with preservation of the MA mobility at the 2-year follow-up.

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