Nova abordagem técnica para papilopexia cruzada em operação de substituição valvar mitral: resultados imediatos

Gomes, Otoni Moreira; Gomes, Eros Silva; Filho, Geraldo Paulino Santana; Pontes, José Carlos Dorsa Vieira; Benfatti, Ricardo Adala

doi:10.1590/s0102-76382005000300018

Cited by 5 publications

(11 citation statements)

References 17 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: 77%

“…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%

“…We also consider studies that prove that the crossing of the papillary muscles and prosthesis implantation in mitral valve replacement, as proposed by Gomes [17], Gomes et al [19], and Santana Filho [23]. The aim of this study is to analyze the short-and mid-term results for patients with mitral valve insufficiency who underwent mitral valve replacement with the technique of crossed papillopexy and annular constriction.…”

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: 77%

Section: Introductionmentioning

confidence: 99%

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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Avaliação ecocardiográfica de pacientes submetidos à cirurgia mitral com papilopexia cruzada

Filho¹,

Gomes²,

Oliveira³

et al. 2009

Arq. Bras. Cardiol.

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Mitral valve replacement with the preservation of the entire valve apparatus

Alsaddique¹

2007

Rev Bras Cir Cardiovasc

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Substituição da valva mitral com preservação do aparato completo da valvaMitral valve replacement with the preservation of the entire valve apparatus Abstract Objective: The papillary muscles and the chordae tendineae of both mitral leaflets contribute to the preservation of the left ventricular function. Most surgeons, however, routinely excise the anterior mitral leaflet.Methods: In a group of nine patients, six of them underwent mitral valve replacement alone and three underwent both aortic and mitral valve replacements, all the mitral apparatus was preserved. All of these patients had mechanical valves using CarboMedics cardiac prosthesis (CarboMedics, Inc. Austin, Texas).Results: There was no mortality. Postoperative echocardiographic assessment revealed maintained left ventricular function with no interference with the prosthetic leaflet mobility and no left ventricular outflow tract gradient.Conclusion: We believe that in most patients with longstanding mitral valve regurgitation, thinned out papillary muscles and elongated chordae tendineae that are not amenable to repair, valve replacement with the preservation of the entire native valve is possible and should be encouraged. This is especially valuable for those with depressed left ventricular function, who might otherwise suffer from left ventricular dysfunction in the long-term if the entire mitral valve apparatus were to be excised.Descriptors: Mitral valve, surgery. Mitral valve insufficiency, surgery. Heart valve prosthesis implantation, methods. 219ALSADDIQUE, AA -Mitral valve replacement with the preservation of the entire valve apparatus Braz J Cardiovasc Surg 2007; 22(2): 218-223

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Nova abordagem técnica para papilopexia cruzada em operação de substituição valvar mitral: resultados imediatos

Abstract: Nova abordagem técnica para papilopexia cruzada em operação de substituição valvar mitral: resultados imediatos

Cited by 5 publications

References 17 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

Avaliação ecocardiográfica de pacientes submetidos à cirurgia mitral com papilopexia cruzada

Mitral valve replacement with the preservation of the entire valve apparatus

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