Treatment of severe functional mitral regurgitation: Is cardiac surgery always indicated?
Department of Cardiovascular Services, Royal Columbian Hospital, 301 E. Columbia Street, Suite 206, New Westminster, British Columbia, V3L 3W5, Canada. The Journal of invasive cardiology
(Impact Factor: 0.95).
Severe functional mitral regurgitation associated with myocardial ischemia is conventionally a Class I indication for cardiac surgery. Mitral annuloplasty or mitral valve replacement are performed during coronary bypass surgery with the aim of improving the patient's ventricular function and symptoms. With the advancement of stent technology, sustained myocardial perfusion and improvement of ventricular function could be achieved by revascularization alone, leading to a reduction in the severity of mitral regurgitation. The purpose of this case is to review the role of transcatheter coronary revascularization in the management of myocardial ischemia associated with severe functional mitral regurgitation and heart failure.
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ABSTRACT: To show the complications that increase the permanence at intensive care unit (ICU) of the patients submitted to cardiac surgery.
Eighty-five handbooks of patients submitted to cardiac surgery had been analyzed, retrospectively, from March to May 2009 at Santa Casa de Misericórdia de Juiz de Fora (MG)--Brazil--and 14 (16.47%) patients had been studied. They remained more than 5 days at ICU. In 85 patients occurred three deaths: two patients operated in urgency character and this increases the morbidity; one patient who remained in mechanical ventilation (MV) by 21 days.
Complications that had increased the time of hospitalization at ICU had been respiratory and metabolic in accordance with literature.
Complications that increase the time of permanence at ICU are those related to respiratory function, chronic obstructive pulmonary disease, tabagism, pulmonary congestion, time of permanence under MV, diabetes, infections, renal insufficiency, stroke and hemodynamic instability.
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