Résumé
PURPOSE: The dura mater bioprosthesis was developed in the Department of Cardiopneumology of the Hospital das Clínicas of the University of Säo Paulo Medical School in 1971. Here, we present the clinical results of the dura mater bioprosthesis over 30 years of follow-up. METHODS: We studied 70 consecutive patients who underwent mitral or tricuspid valve replacement with a dura mater bioprosthesis between January 1971 and August 1972. RESULTS: The early mortality was 10 percent (7 patients). The follow-up was 87 percent complete (9 patients were lost to follow-up). Two patients were alive and asymptomatic 30 years after valve replacement; 33 patients underwent reoperations due to valve dysfunction, and 19 died during the follow-up period. At 30 years, the actuarial survival was 49.2 ± 8.6 percent; freedom from rupture, 27.0 ± 10.2 percent; freedom from calcification, 78.8 ± 8.6 percent; and freedom from reoperation, 18.8 ± 7.5 percent. CONCLUSIONS: The dura mater bioprosthesis played an important role in the treatment of patients with mitral and tricuspid valve disease. The low rate of thromboembolism and the long period of follow-up without evidence of valve dysfunction, which occurred for several of our patients, are important characteristics of these bioprosthesis
Sujets)
Humains , Mâle , Femelle , Adolescent , Adulte , Adulte d'âge moyen , Bioprothèse , Prothèse valvulaire cardiaque , Valve atrioventriculaire gauche , Insuffisance mitrale , Valve atrioventriculaire droite , Insuffisance tricuspide , Brésil , Dure-mère , Études de suivi , Prothèse valvulaire cardiaque , Insuffisance mitrale , Conception de prothèse , Insuffisance tricuspideRésumé
De janeiro de 1982 a março de 1984, foram implantadas 170 biopróteses de pericárdio bovino e alto perfil, no Instituto do Coraçao do Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, com mortalidade hospitalar de 7,1 por cento. Através do estudo anatomopatológico, foram identificados cinco casos em que ocorreu obstruçao da via de saída do ventrícuio esquerdo após substituiçao da valva mitral. Com base nessa experiência, a indicaçao de estudo hemodinâmico no 1( dia de pós-operatório em paciente em baixo débito, sem explicaçao, possibilitou identificar obstruçao da via de saída do ventrículo esquerdo, com retroca valvar e boa evoluçao. Neste trabalho, sao relatados detalhadamente os seis casos e discutidas as causas da obstruçao da via de saída na substituiçao mitral.