Mitral valve replacement and remodeling of the left ventricle in dilated cardiomyopathy with mitral regurgitation. Initial results
Arq. bras. cardiol
;
78(2): 224-229, Feb. 2002. ilus, tab
Article
in English
| LILACS
| ID: lil-303907
ABSTRACT
OBJECTIVE:
This study evaluated the effects of a new method of mitral valve replacement on left ventricular (LV) remodeling and heart failure functional class.METHODS:
Eight patients (6 men) with severe mitral regurgitation from end-stage dilated cardiomyopathy underwent surgery. Five patients were in functional class (FC) IV, 2 were in FC III and 1 was in FC III/IV. Age ranged from 33 to 63 years. Both the anterior and posterior leaflets of the mitral valve were divided into hemileaflets. The resultant 4 pedicles were displaced under traction toward the left atrium and anchored between the mitral annulus and an implanted valvular prosthesis. The beating heart facilitated ideal chordae tendineae positioning.RESULTS:
All patients survived and were discharged from the hospital. After a mean follow-up period of 6.5 months (1-12 m), 5 patients were in FC I; 2 in FC I/II; and 1 in FC II. The preoperative ejection fraction ranged from 19 percent to 30 percent (mean 25.7±3.4 percent), and the postoperative ejection fraction ranged from 21 percent to 40 percent (mean 31.1± 5.8 percent). Doppler echocardiography showed evidence of LV remodeling in 4 patients, including lateral wall changes and a tendency of the LV cavity to return to its elliptical shape.CONCLUSION:
This technique of mitral valve replacement, involving new positioning of the chordae tendineae, allowed LV remodeling and improvement in FC during this brief follow-up period
Full text:
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Index:
LILACS (Americas)
Main subject:
Cardiomyopathy, Dilated
/
Heart Valve Prosthesis Implantation
/
Ventricular Remodeling
/
Mitral Valve
/
Mitral Valve Insufficiency
Type of study:
Observational study
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Arq. bras. cardiol
Journal subject:
Cardiology
Year:
2002
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de Säo Paulo/BR
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