PMID- 11178286
OWN - NLM
STAT- MEDLINE
DCOM- 20010510
LR  - 20161124
IS  - 1098-3511 (Print)
IS  - 1098-3511 (Linking)
VI  - 3
IP  - 4
DP  - 2000
TI  - Mitral valve repair in rheumatic patients.
PG  - 273-6
AB  - BACKGROUND: There is controversy regarding the role of reparative techniques for 
      rheumatic-mitral valve disease. We have analyzed the late results of mitral valve 
      repair in a group of patients with rheumatic mitral valve insufficiency. METHODS: 
      From March 1980 to December 1997, 201 patients with rheumatic fever underwent 
      mitral valve repair at the Heart Institute, Hospital das Clinicas, Medical 
      School, University of Sao Paulo. The mean age of patients was 26.9 +/- 15.4 
      years, with 59.7% of the patients being female. Other diagnoses were present in 
      67.7% of patients; the most common was tricuspid regurgitation (31.3%). Mitral 
      valve repair techniques included: 1) Carpentier ring annuloplasty in 75 patients 
      (37.3%); 2) posterior annuloplasty with bovine patch in 68 patients (33.8%); 3) 
      posterior segmental annuloplasty in 16 patients (7.9%); 4) quadrangular resection 
      of the posterior leaflet with ring plication in 11 patients (5.5%); 5) partial 
      resection of the anterior leaflet in 6 patients (3%); 6) De Vega's annuloplasty 
      in 6 patients (3%); 7) Kay's annuloplasty in 5 patients (2.5%); 8) Reed's 
      annuloplasty in 4 patients (2%); and 9) miscellaneous techniques in 10 patients 
      (4.9%). Combined techniques were used in 94 patients (46.8%), the most frequent 
      of which was chordal shortening (48 patients, 23.9%). Other non-mitral cardiac 
      procedures were performed in 113 patients (56.2%). Actuarial survival and 
      event-free curves (Kaplan-Meier method) were compared by linear regression 
      analysis. RESULTS: The in-hospital mortality rate was 2.0% (four patients). The 
      causes of death were multiorgan failure in two patients and low cardiac output in 
      the other two patients. In the late postoperative period, 83.9% of the patients 
      were in New York Heart Association (NYHA) functional class 1. The actuarial 
      survival was 93.9% +/- 1.9% at a mean of 125 months. Twenty-three patients were 
      reoperated in the postoperative period at a mean interval of 35.7 months. 
      Survival free from reoperation was 43.3% +/- 13.7% at 125 months. When analyzing 
      the patients according to age, actuarial survival was 91.3% +/- 3.8% in the group 
      of patients younger than 16 years (Group 1), compared with 95.6% +/- 2.7% in the 
      group older than 16 years (Group 2), with a statistically significant difference 
      of p < 0.0001. Survival free from reoperation was 50.8% +/- 16.9% in Group 1 and 
      47.0% +/- 14.9% in Group 2 (p < 0.0001). CONCLUSIONS: Late results obtained with 
      mitral valve repair for rheumatic mitral valve insufficiency were satisfactory 
      and exceeded those reported for mitral valve replacement in the same population.
FAU - Pomerantzeff, P M
AU  - Pomerantzeff PM
AD  - Heart Institute, Hospital das Clinicas, Medical School, University of Sao Paulo, 
      Brazil.
FAU - Brandao, C M
AU  - Brandao CM
FAU - Faber, C M
AU  - Faber CM
FAU - Grinberg, M
AU  - Grinberg M
FAU - Cardoso, L F
AU  - Cardoso LF
FAU - Tarasoutchi, F
AU  - Tarasoutchi F
FAU - Stolf, N A
AU  - Stolf NA
FAU - Verginelli, G
AU  - Verginelli G
FAU - Jatene, A D
AU  - Jatene AD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Heart Surg Forum
JT  - The heart surgery forum
JID - 100891112
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Brazil
MH  - Cardiac Surgical Procedures/methods
MH  - Child
MH  - Child, Preschool
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Survival
MH  - *Heart Valve Prosthesis
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Mitral Valve Insufficiency/diagnostic imaging/*mortality/*surgery
MH  - Retrospective Studies
MH  - Rheumatic Heart Disease/diagnostic imaging/mortality/*surgery
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2001/02/15 11:00
MHDA- 2001/05/22 10:01
CRDT- 2001/02/15 11:00
PHST- 2001/02/15 11:00 [pubmed]
PHST- 2001/05/22 10:01 [medline]
PHST- 2001/02/15 11:00 [entrez]
PST - ppublish
SO  - Heart Surg Forum. 2000;3(4):273-6.