Management of endomyocardial fibrosis: Successful surgical treatment of biventricular involvement and consideration of the superiority of operative intervention

Graham, Joseph M.; Lawrie, Gerald M.; Feteih, Nizar; DeBakey, Michael E.

doi:10.1016/0002-8703(81)90104-6

Cited by 20 publications

(13 citation statements)

References 27 publications

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“…It has been recognized in other areas [7][8][9][10][11][12]. We recognized this disease in the Middle East for the first time in 1980 [4,5]. In Saudi Arabia, the disease can mimic the more common rheumatic valvular disease and tuberculous constrictive pericarditis.…”

Section: Discussionmentioning

confidence: 98%

Endomyocardial Fibrosis: Clinical, Echocardiographic and Hemodynamic Findings

et al. 1993

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Section: Discussionmentioning

confidence: 98%

Endomyocardial Fibrosis: Clinical, Echocardiographic and Hemodynamic Findings

et al. 1993

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“…The right ventricular angiogram shows loss of trabeculated pattern, flattened apex, reduction of the ventricular volume, dilated and hypercontractile infundibulum, free tricuspid reflux, large right atrium, and dilated cava veins [68].…”

Section: Cardiac Catheterizationmentioning

confidence: 97%

“…Surgery is indicated in all EMF patients in NYHA class III and IV who have structural lesions [68,71,72]. However, surgery is associated to high morbidity and mortality [71,73].…”

Section: Surgical Managementmentioning

confidence: 99%

Endomyocardial Fibrosis

Mocumbi¹

2013

Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care

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Endomyocardial fibrosis (EMF) is an idiopathic disorder of the tropical and subtropical regions of the world. It is the commonest cause of restrictive cardiomyopathy and affects an estimated 10 million people worldwide mainly children and adolescents from Africa, South America, and Asia.The etiology and pathogenesis of EMF remain unknown, since none of the factors that have been postulated for its origin can fully explain the occurrence worldwide. EMF might be caused by one or several environmental factors acting upon genetically predisposed individuals. Attempts to relate the condition to infections, dietary factors, and toxic agents failed to unveil the exact etiology and pathogenesis.

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“…30 Open heart surgery increases survival compared with medical treatment. 10,43,[147][148][149][150][151][152][153][154][155] Access to heart surgery, however, is severely limited in many endemic areas. Where expertise exists, EMF may be successfully treated with surgical endocardectomy and valve repair/replacement.…”

Section: Current Management Strategiesmentioning

confidence: 99%

Tropical Endomyocardial Fibrosis

et al. 2016

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Abstract-Tropical endomyocardial fibrosis (EMF) is a neglected disease of poverty that afflicts rural populations in tropical low-income countries, with some certain high-prevalence areas. Tropical EMF is characterized by the deposition of fibrous tissue in the endomyocardium, leading to restrictive physiology. Since the first descriptions in Uganda in 1948, high-frequency areas for EMF have included Africa, Asia, and South America. Although there is no clear consensus on a unified hypothesis, it seems likely that dietary, environmental, and infectious factors may combine in a susceptible individual to give rise to an inflammatory process leading to endomyocardial damage and scar formation. The natural history of EMF includes an active phase with recurrent flare-ups of inflammation evolving to a chronic phase leading to restrictive heart failure. In the chronic phase, biventricular involvement is the most common presentation, followed by isolated right-sided heart disease. Marked ascites out of proportion to peripheral edema usually develops as a typical feature of EMF. EMF carries a very poor prognosis. In addition to medical management of heart failure, early open heart surgery (endocardectomy and valve repair/replacement) appears to improve outcomes to some extent; however, surgery is technically challenging and not available in most endemic areas. Increased awareness among health workers and policy makers is the need of the hour for the unhindered development of efficient preventive and therapeutic strategies.

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Management of endomyocardial fibrosis: Successful surgical treatment of biventricular involvement and consideration of the superiority of operative intervention

Cited by 20 publications

References 27 publications

Endomyocardial Fibrosis: Clinical, Echocardiographic and Hemodynamic Findings

Endomyocardial Fibrosis: Clinical, Echocardiographic and Hemodynamic Findings

Endomyocardial Fibrosis

Tropical Endomyocardial Fibrosis

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