Treatment of severe functional mitral regurgitation: Is cardiac surgery always indicated?

ArticleinThe Journal of invasive cardiology 19(10):E286-9 · November 2007with3 Reads
Source: PubMed
Abstract
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.
    • "Devido à instabilidade hemodinâmica que pode acontecer no pós-operatório imediato, o paciente pode precisar de drogas vasoativas (DVA) e permanecerá na Unidade de Tratamento Intensivo (UTI) enquanto houver necessidade151617. Os controles de dados vitais, como glicemia capilar e monitorização, são realizados de hora em hora, o que também pode trazer desconforto ao paciente [2,18192021. As doenças sistêmicas, principalmente as respiratórias e metabólicas, como doença pulmonar obstrutiva crônica (DPOC) e diabetes, podem aumentar o tempo de permanência na UTI e, em alguns casos, aumentar o tempo de VM [3,9,18]. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: To show the complications that increase the permanence at intensive care unit (ICU) of the patients submitted to cardiac surgery. Methods: 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. Results: Complications that had increased the time of hospitalization at ICU had been respiratory and metabolic in accordance with literature. Conclusion: 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.
    Full-text · Article · Jun 2010
  • [Show abstract] [Hide abstract] ABSTRACT: Objective: To analyze the incidence of functional mitral regurgitation (FMR),post-operation characteristics and operation indications of Marfan patients with severe aortic regurgitation and giant left ventricle. Methods: The clinical data and the follow-up data of 19 Marfan patients with severe aortic regurgitation (≥10 ml) and giant left ventricle (LVEDd≥7.0 cm), who were treated from Jan. 2000 to Dec. 2007,were analyzed retrospectively. Results: All patients received Bentall operation and there was no perioperation death. Follow-up was 72 patient-year (ranging 3 months-7 years). The degree of FMR decreased obviously after operation, with an improvement rate of 87.5%, and the FMR almost disappeared 6 months to 1 year later. Conclusion: Bentall achieves good outcome in Marfan patients with severe aortic regurgitation and giant left ventricle. Mild to moderate FMR(< 10 ml) disappears with the decrease of the left ventricle size. For patients with severe FMR (≥ 10 ml) complicated with dysfunction of left ventricle, managed ventricular pacing is suggested.
    Article · Nov 2008
  • [Show abstract] [Hide abstract] 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.
    Article · Jun 2010

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