Plástica valvar mitral pela técnica de "Duplo Teflon" em pacientes com anel valvar calcificado e degeneração mixomatosa

Abstract

Objective: The purpose of this study is to present the immediate and long-term results of mitral valve repair using the double Teflon technique in patients with mitral insufficiency due to myxomatous disease and severely calcified annuli. Method: Between 1985 and 2002, 162 patients with mitral valve insufficiency due to myxomatous degeneration were submitted to mitral valve repair in the Heart Institute of University of São Paulo Medical School. From these, 13 presented severely calcified annuli and underwent mitral valve repair with quadrangular resection and annuloplasty using the double Teflon technique. The mean patient age was 65.4 ± 12.9 years with 69.2% of the patients being male. One (7.7%) patient had associated coronary artery disease and was submitted to coronary artery bypass grafting. In the preoperative period, 15.4% of the patients were in functional class IV of the New York Heart Association, 69.2% in class III and 15.4% in class II. Results: There were no operative deaths. In late postoperative period 90.9% of the surviving patients were in functional class I. There were no episodes of hemolysis or endocarditis. One patient was reoperated in the second postoperative month and was submitted to mitral valve replacement. The actuarial survival at 14 years was 71.4% ± 17.1%. Conclusions: Mitral valve repair using the double Teflon technique in patients with myxomatous disease and severely calcified annuli presented satisfactory survival rates and good clinical evolution which proved to be a better alternative than mitral valve replacement.

Análise do efeito do laser de alta potência em valvas mitrais cardíacas de suínos: estudo experimental

“…Elas incluem a insuficiência mitral nos seus mais variados graus. O mecanismo mais freqüente desta insuficiência é o alongamento ou rotura de cordas 32 . Segundo SAVAGE et al (1983), a calcificação do anel mitral em valva mixomatosa é um processo degenerativo que envolve o esqueleto fibroso do coração, resultando em aumento do estresse no aparelho valvar mitral 33 .…”