No período de março de 1982 a dezembro de 1995 foram implantadas biopróteses de pericárdio bovino Fisics-Incor em 2259 pacientes. A média de idade foi de 47,2 ± 17,5 anos e 55% eram do sexo masculino. A principal etiologia das lesões foi a febre reumática em 1031 (45,7%) pacientes. Foram realizadas 1073 substituições da valva aórtica, 1085 mitral, 195 mitro-aórtica, 27 tricúspide e 16 substituições combinadas. Cirurgias associadas foram realizadas em 788 (32,9%) pacientes, predominando a plástica da valva tricúspide (9,2%) e a revascularização do miocárdio (7,7%). A mortalidade hospitalar global foi de 194 (8,6%) pacientes, 8,6% na substituição mitral isolada, 4,7% na aórtica e 12,8% na mitro-aórtica. As taxas linearizadas para os eventos calcificação, tromboembolismo, rotura, escape e endocardite são, respectivamente: 1,1%; 0,2%; 0,9%; 0,1% e 0,5% pacientes/ano. A curva actuarial de sobrevida é de 56,7% ± 5,4% em 15 anos. Livre de endocardite foi de 91,9% ± 2%, livre de tromboembolismo de 95 ± 1,7%, livre de rotura de 43,7 ± 19,8%, livre de escape 98,9 ± 4,5% e livre de calcificação de 48,8 ± 7,9% em 15 anos. No pós-operatório tardio 1614 (80,6%) pacientes encontram-se em classe funcional I (NYHA). Podemos concluir que os pacientes submetidos a implante de biopróteses de pericárdio bovino apresentaram evolução satisfatória.
Between March 1982 and December 1995, 2607 Fisics-Incor bovine pericardial bioprostheses were implanted in 2259 patients. The average age was 47.2 ± 17.5 years, and 55% were male. Rheumatic fever was present in 1031 (45.7%) patients. We performed 1073 aortic valve replacements, 1085 mitral replacements, 27 tricuspid replacements, 195 mitral-aortic replacements, and other 16 combined valve replacements. There were associated procedures in 788 (32.9%) patients, the most frequent being tricuspid valve repair (9.2%) and myocardial revascularization (7.7%). The hospital mortality was 194 (8.6%) patients, 8.6% for the mitral group, 4.7% for the aortic, and 12.8% for the double valve replacements. The linearized rates for calcification, thromboembolism, rupture, leak and endocarditis were, respectively, 1.1%; 0.2%; 0.9%; 0.1% and 0.5% patient-year. The actuarial survival curve was 56.7 ± 5.4% in 15 years. Free from endocarditis was 91.9 ± 2%, thromboembolism 95 ± 1,7%, rupture 43.7 ± 9.8%, leak 98.9 ± 4.5%, and calcification 48.8 ± 7.9% in 15 years. In the late post-operative period, 1614 (80.6%) patients were in NYHA functional class I. We conclude that the results with the Fisics-Incor bovine pericardial bioprostheses were satisfactory in our group of patients
A 20-year-old woman sought medical care due to headache and vomiting following syncope (9/22/95).The patient was born from an uneventful normal delivery at the end of a full-term pregnancy. Up to the age of 1 year and 6 months, the patient had fatigue when being fed. At the age of 7 years, she began to have fatigue on strenuous exertion and palpitations during tense situations. At the age of 8 years, she had 2 episodes of cyanosis and dyspnea on exertion accompanied by the sensation of imminent loss of consciousness. She also complained of arthralgia in her knees and ankles, and pain in her thoracic and lumbar spine. At the age of 9 years, the patient was referred to our hospital (11/26/84).The physical examination at that time (11/26/84) showed an eupneic and acyanotic child, with a regular and symmetric pulse. The heart rate was 72bpm and blood pressure was 120/90mmHg. The lung examination was normal. The heart examination showed an increased intensity of the second cardiac sound, which was palpable in the pulmonary area, where a systolic murmur could also be heard. The liver was palpated in the right costal margin, and no edema of the lower limbs was observed.The electrocardiogram (11/23/84) showed sinus rhythm, a heart rate of 79bpm, QRS axis of +110° forward, and right ventricular hypertrophy ( fig. 1). The chest X-ray showed enlargement of the right ventricle and bulging of the pulmonary trunk. Laboratory tests are shown in table I. The search for lupus erythematosus cells, antinuclear factor, and rheumatoid factor was negative.The echocardiogram (10/3/85) disclosed an aneurysm
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