Substituição da valva mitral com tração dos músculos papilares em pacientes com miocardiopatia dilatada

Gaiotto, Fábio Antônio; Puig, Luiz Bóro; Mady, Charles; F, Fernandes; Tossuniam, Carlos Eduardo; Pardi, Miriam Magalhães; Dallan, Luís Alberto Oliveira; Oliveira, Sérgio Almeida de; Ramires, Jose F.; Pomerantzeff, Pablo Maria Alberto

doi:10.1590/s0102-76382007000100013

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…The absence of operative mortality and mechanical ventricular assistance mechanism presented in this study, compared with the other papers previously mentioned [14][15][16][17][18][19][20][21][22][23], may be explained by the fact that the crossing of the papillary muscles has allowed for left ventricular diastolic containment. Similarly, the annular constriction due to the implantation of an undersized prosthesis promotes the base ventricular remodeling, allowing improvement of cardiac performance.…”

Section: Discussionmentioning

confidence: 42%

“…The higher survival rates shown in this study compared with other mitral valve approaches forementioned [14][15][16][17][18][19][20][21][22][23] is probably due to the immediate improvement of ventricular performance in short-term (this factor may be considered to be a predictor of increased survival). It is possible that in a long-term follow-up, this improvement of ventricular performance can be a determining factor in increased survival rates.…”

Section: Discussionmentioning

confidence: 76%

“…A new possibility then arose: surgically approaching the mitral valve in patients with severe left ventricular dysfunction in order to improve ventricular performance. This possibility may be included in the surgical and therapeutic tools to combat advanced heart failure [14][15][16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors [14][15][16][17][18][19][20][21][22][23] have shown that the correction of mitral valve insufficiency in patients with severe left ventricular dysfunction -whether due to valvuloplasty or to valve replacement with preservation of subvalvar apparatus -was associated with low operative mortality and improves survival in the short-and mid-term.…”

Section: Introductionmentioning

confidence: 99%

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Substituição valvar mitral com papilopexia cruzada e constrição anular em pacientes com insuficiência cardíaca

Benfatti¹,

Pontes²,

Gomes³

et al. 2008

Rev Bras Cir Cardiovasc

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Substituição valvar mitral com papilopexia cruzada e constrição anular em pacientes com insuficiência cardíacaMitral valve replacement with crossed papillopexy and annular constriction in heart failure patients Abstract Objective: To analyze the short-term and mid-term followups of patients with heart failure and moderate to severe mitral valve insufficiency and who have undergone mitral valve replacement with crossed papillopexy and annular constriction.Methods: Thirteen patients in NYHA functional class III or IV, with a mean age of 54.1 years and with idiopathic etiology, underwent mitral valve replacement with ring constriction and crossed papillopexy. Echocardiograph parameters, functional class and survival actuarial curve were analyzed.Results: There were no deaths during surgery or in the postoperative period. The mean left ventricular diastolic diameter was reduced from 71 ± 8.6 mm to 65.3 ± 8.6 mm (p=0.049) and the mean left ventricular systolic diameter was reduced from .1 ± 8.5 mm to 50.4 ± 11.1 mm (p=0.002). The atrial diameters varied from 49.4 ± 6.4 mm to 44 ± 5.9 mm (p=0.017); the percentage of the left ventricular shortening was 17 ± 4 % to 24 ± 8.3% (p=0.014); the ejection fraction varied statistically and significantly from 34 ± 9% to 45 ± 14% (p=0.008). Eleven (84.6%) patients were in FC I and II. At 1, 6 and 12 months after follow-up surgery, the survival rate was 100%, 82.6%, 71.6%, respectively. This rate was maintained at 7.6% for more than 36 months. Conclusion:The results obtained from patients with heart failure and moderate to severe mitral valve insufficiency and who underwent mitral valve replacement with crossed papillopexy and annular constriction presented evidence of improved heart remodeling and significant improvement in left ventricular performance.

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Substituição valvar mitral com papilopexia cruzada e constrição anular em pacientes com insuficiência cardíaca

Benfatti¹,

Pontes²,

Gomes³

et al. 2008

Rev Bras Cir Cardiovasc

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“…In mid-to long-term follow-up [86], the results were favorable in terms of symptoms. There was also a reduction of left ventricular systolic and diastolic end volumes until the 3rd month of postoperative, with stabilization of the process of cardiac remodeling so on.…”

Section: Brazilian Contribution In the Correction Of The Functional Mmentioning

confidence: 84%

Cirurgia da insuficiência mitral no tratamento da insuficiência cardíaca avançada

Oliveira¹,

Vicente²,

Rodrigues³

et al. 2009

Rev Bras Cir Cardiovasc

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New Evidence Supporting a Novel Conceptual Framework for Distinguishing Proportionate and Disproportionate Functional Mitral Regurgitation

Packer

Grayburn

2020

JAMA Cardiol

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ImportanceTraditionally, physicians distinguished between mitral regurgitation (MR) as a determinant of outcomes and MR as a biomarker of left-ventricular (LV) dysfunction by designating the lesions as primary or secondary, respectively. In primary MR, leaflet abnormalities cause the MR, resulting in modest increases in LV end-diastolic volume over time, whereas in patients with classic secondary MR, LV dysfunction and dilatation lead to MR without structural leaflet abnormalities. However, certain patients with global LV disease (eg, those with left bundle branch block or regional wall motion abnormalities) have the features of primary MR and might respond favorably to interventions that aim to restore the proper functioning of the mitral valve apparatus.ObservationsA novel conceptual framework is proposed, which classifies patients with meaningful LV disease based on whether the severity of MR is proportionate or disproportionate to the LV end-diastolic volume. Treatments that reduce LV volumes (eg, neurohormonal antagonists) are effective in proportionate MR but not disproportionate MR. Conversely, procedures that restore mitral valve function (eg, cardiac resynchronization and mitral valve repair) are effective in patients with disproportionate MR but not in those with proportionate MR. The proposed framework explains the discordant findings in the Multicentre Randomized Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) and the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) trials; differences in procedural success and medical therapy in the 2 studies cannot explain the different results. In addition, the small group of patients in the COAPT trial who had the features of proportionate MR and were similar to those enrolled in the MITRA-FR trial did not respond favorably to transcatheter mitral valve repair.Conclusions and RelevanceThe characterization of patients with functional MR into proportionate and disproportionate subtypes may explain the diverse range of responses to drug and device interventions that have been observed.

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Substituição da valva mitral com tração dos músculos papilares em pacientes com miocardiopatia dilatada

Abstract: This technique of mitral valve replacement improved the left ventricle ejection fraction and decreased the end diastolic and systolic diameters and the end systolic diastolic volumes up to the third month of follow-up. From then on the variables stabilized.

Cited by 9 publications

References 26 publications

Substituição valvar mitral com papilopexia cruzada e constrição anular em pacientes com insuficiência cardíaca

Substituição valvar mitral com papilopexia cruzada e constrição anular em pacientes com insuficiência cardíaca

Cirurgia da insuficiência mitral no tratamento da insuficiência cardíaca avançada

New Evidence Supporting a Novel Conceptual Framework for Distinguishing Proportionate and Disproportionate Functional Mitral Regurgitation

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