Plastia mitral cirúrgica em crianças com febre reumática

Silva, Andréa Rocha e; Herdy, Gesmar Volga Haddad; Vieira, Alan Araújo; Simöes, Luiz Carlos

doi:10.1590/s0066-782x2009000600004

Cited by 7 publications

(9 citation statements)

References 14 publications

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“…16 Therefore, in the absence of evidence from randomized clinical trials, the decision to interfere in a patient with RHD relies on an individual risk-benefit analysis suggesting that improvement of prognosis, as compared with natural history, outweighs the risk of intervention and its potential late consequences, particularly prosthesis-related complications. 17 In our study, 63% of the patients with RHD had had previous surgical intervention, and 70% of these had been subjected to valve replacement." Length of stay appears also to be prolonged in RHD because of a need for long-term anticoagulation.…”

Section: Impact Of Rheumatic Fever On Morbidity After Thoracic Surgerymentioning

confidence: 60%

Determinants of prolonged length of hospital stay after cardiac surgery: impact of rheumatic heart disease

Pato¹,

Gelape²,

Cassiano³

et al. 2015

Medical Express

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Section: Impact Of Rheumatic Fever On Morbidity After Thoracic Surgerymentioning

confidence: 60%

Determinants of prolonged length of hospital stay after cardiac surgery: impact of rheumatic heart disease

Pato¹,

Gelape²,

Cassiano³

et al. 2015

Medical Express

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“…From Groves and Effler’s description in 1954 [5] until 2007, Silva reported that 114 cases of “primary” or “idiopathic” chylopericardium had been described in the literature [6]. We have found 14 new cases reported since 2007, with a total of 128 cases described up to November 2013.…”

Section: Discussionmentioning

confidence: 90%

Primary idiopathic chylopericardium: a retrospective case series

Han

Jing

et al. 2015

BMC Surg

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BackgroundPrimary idiopathic chylopericardium is a rare clinical entity characterized by the accumulation of chyle within the pericardial cavity without a definitive cause. The aim of this study was to assess the clinical presentation, etiology, diagnosis, treatment and follow-up of primary idiopathic chylopericardium.MethodsWe retrospectively reviewed 9 cases of patients who suffered from primary idiopathic chylopericardium at our hospital from January 1993 to November 2013.ResultsThere were two males and seven females among our patients. Their ages ranged from 13 to 55 years. The most common clinical presentation was dyspnea. The etiology was idiopathic. All patients were diagnosed by pericardiocentesis, computed tomography of the chest and lymphoscintigraphy. Non-surgical therapy was adopted in all nine patients and failed in six, who underwent subsequent successful surgery. Thoracic duct ligation with the creation of a pericardial window was the most common surgical procedure. All patients were followed up from 3 months to 9 years, and no recurrence occurred.ConclusionsIn assessing patients with an enlarged cardiac silhouette, one should be aware of primary idiopathic chylopericardium. The most effective treatment is ligation of the thoracic duct and the creation of a pericardial window.

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“…MVP is universally accepted as superior to valve replacement (bioprostheses or metal prostheses), especially in children in whom growth, problems with anticoagulation, thromboembolism, rapid valve degeneration, increased risk of endocarditis and less preservation of ventricular function are unfavourable factors to this technique. [6][7][8][10][11][12] In the tertiary hospital in which the study was performed, MVP is the preferred technique.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease

Cruz

Santos

et al. 2019

Arquivos Brasileiros De Cardiologia

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Background: Mitral valve repair in paediatric patients with chronic rheumatic heart disease is superior to valve replacement and has been used with good results.Objective: To identify predictors of unfavourable outcomes in children and adolescents submitted to surgical mitral valvuloplasty secondary to rheumatic heart disease.Methods: Retrospective study of 54 patients under the age of 16 operated at a tertiary paediatric hospital between March 2011 and January 2017. The predictors of risk for unfavourable outcomes were: age, ejection fraction, degree of mitral insufficiency, degree of pulmonary hypertension, presence of tricuspid insufficiency, left chamber dilation, preoperative functional classification, duration of cardiopulmonary bypass, duration of anoxia, presence of atrial fibrillation, and duration of vasoactive drug use. The outcomes evaluated were: death, congestive heart failure, reoperation, residual mitral regurgitation, residual mitral stenosis, stroke, bleeding and valve replacement. For all analyzes a value of p < 0.05 was established as significant.Results: Of the patients evaluated, 29 (53.7%) were female, with an average of 10.5 ± 3.2 years. The functional classification of 13 patients (25%) was 4. There was no death in the sample studied. The average duration of extracorporeal circulation was 62.7±17.8 min, and anoxia 50 ± 15.7 min. The duration of use of vasoactive drug in the immediate postoperative period has an average of 1 day (interquartile interval 1-2 days). The logistic regression model was used to evaluate the predictive variables for each unfavourable outcome. The duration of use of vasoactive drug was the only independent predictor for the outcomes studied (p = 0.007). Residual mitral insufficiency was associated with reoperation (p = 0.044), whereas tricuspid insufficiency (p = 0.012) and pulmonary hypertension (p = 0.012) were associated with the presence of unfavourable outcomes. Conclusion:The duration of vasoactive drug use is an independent predictor for unfavourable outcomes in the immediate and late postoperative period, while residual mitral regurgitation was associated with reoperation, and both tricuspid regurgitation and pulmonary hypertension were associated with unfavourable outcomes.

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Plastia mitral cirúrgica em crianças com febre reumática

Abstract: SummaryBackground: Mitral repair is well accepted in children with rheumatic fever.

Cited by 7 publications

References 14 publications

Determinants of prolonged length of hospital stay after cardiac surgery: impact of rheumatic heart disease

Determinants of prolonged length of hospital stay after cardiac surgery: impact of rheumatic heart disease

Primary idiopathic chylopericardium: a retrospective case series

Predictors of Unfavourable Outcomes in Children and Adolescents Submitted to Surgical Mitral Valvuloplasty Secondary to Chronic Rheumatic Heart Disease

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