Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients

INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Elaine Soraya Barbosa de Oliveira Severino [verfasserIn] Orlando Petrucci [verfasserIn] Karlos Alexandre de Souza Vilarinho [verfasserIn] Carlos Fernando Ramos Lavagnoli [verfasserIn] Lindemberg da Mota Silveira Filho [verfasserIn] Pedro Paulo Martins de Oliveira [verfasserIn] Reinaldo Wilson Vieira [verfasserIn] Domingo Marcolino Braile [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2011

Schlagwörter:	Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis

Übergeordnetes Werk:	In: Brazilian Journal of Cardiovascular Surgery - Sociedade Brasileira de Cirurgia Cardiovascular, 2004, 26(2011), 4, Seite 559-564
Übergeordnetes Werk:	volume:26 ; year:2011 ; number:4 ; pages:559-564

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.5935/1678-9741.20110045

Katalog-ID:	DOAJ043104363

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245	1	0	\|a Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients
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520			\|a INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation.
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allfields	10.5935/1678-9741.20110045 doi (DE-627)DOAJ043104363 (DE-599)DOAJa6863fa259914e62932aecf1f5ad15e8 DE-627 ger DE-627 rakwb eng RD1-811 RC666-701 Elaine Soraya Barbosa de Oliveira Severino verfasserin aut Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation. Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis Surgery Diseases of the circulatory (Cardiovascular) system Orlando Petrucci verfasserin aut Karlos Alexandre de Souza Vilarinho verfasserin aut Carlos Fernando Ramos Lavagnoli verfasserin aut Lindemberg da Mota Silveira Filho verfasserin aut Pedro Paulo Martins de Oliveira verfasserin aut Reinaldo Wilson Vieira verfasserin aut Domingo Marcolino Braile verfasserin aut In Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular, 2004 26(2011), 4, Seite 559-564 (DE-627)324824505 (DE-600)2031026-2 16789741 nnns volume:26 year:2011 number:4 pages:559-564 https://doi.org/10.5935/1678-9741.20110045 kostenfrei https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010 kostenfrei https://doaj.org/toc/0102-7638 Journal toc kostenfrei https://doaj.org/toc/1678-9741 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 26 2011 4 559-564
spelling	10.5935/1678-9741.20110045 doi (DE-627)DOAJ043104363 (DE-599)DOAJa6863fa259914e62932aecf1f5ad15e8 DE-627 ger DE-627 rakwb eng RD1-811 RC666-701 Elaine Soraya Barbosa de Oliveira Severino verfasserin aut Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation. Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis Surgery Diseases of the circulatory (Cardiovascular) system Orlando Petrucci verfasserin aut Karlos Alexandre de Souza Vilarinho verfasserin aut Carlos Fernando Ramos Lavagnoli verfasserin aut Lindemberg da Mota Silveira Filho verfasserin aut Pedro Paulo Martins de Oliveira verfasserin aut Reinaldo Wilson Vieira verfasserin aut Domingo Marcolino Braile verfasserin aut In Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular, 2004 26(2011), 4, Seite 559-564 (DE-627)324824505 (DE-600)2031026-2 16789741 nnns volume:26 year:2011 number:4 pages:559-564 https://doi.org/10.5935/1678-9741.20110045 kostenfrei https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010 kostenfrei https://doaj.org/toc/0102-7638 Journal toc kostenfrei https://doaj.org/toc/1678-9741 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 26 2011 4 559-564
allfields_unstemmed	10.5935/1678-9741.20110045 doi (DE-627)DOAJ043104363 (DE-599)DOAJa6863fa259914e62932aecf1f5ad15e8 DE-627 ger DE-627 rakwb eng RD1-811 RC666-701 Elaine Soraya Barbosa de Oliveira Severino verfasserin aut Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation. Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis Surgery Diseases of the circulatory (Cardiovascular) system Orlando Petrucci verfasserin aut Karlos Alexandre de Souza Vilarinho verfasserin aut Carlos Fernando Ramos Lavagnoli verfasserin aut Lindemberg da Mota Silveira Filho verfasserin aut Pedro Paulo Martins de Oliveira verfasserin aut Reinaldo Wilson Vieira verfasserin aut Domingo Marcolino Braile verfasserin aut In Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular, 2004 26(2011), 4, Seite 559-564 (DE-627)324824505 (DE-600)2031026-2 16789741 nnns volume:26 year:2011 number:4 pages:559-564 https://doi.org/10.5935/1678-9741.20110045 kostenfrei https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010 kostenfrei https://doaj.org/toc/0102-7638 Journal toc kostenfrei https://doaj.org/toc/1678-9741 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 26 2011 4 559-564
allfieldsGer	10.5935/1678-9741.20110045 doi (DE-627)DOAJ043104363 (DE-599)DOAJa6863fa259914e62932aecf1f5ad15e8 DE-627 ger DE-627 rakwb eng RD1-811 RC666-701 Elaine Soraya Barbosa de Oliveira Severino verfasserin aut Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation. Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis Surgery Diseases of the circulatory (Cardiovascular) system Orlando Petrucci verfasserin aut Karlos Alexandre de Souza Vilarinho verfasserin aut Carlos Fernando Ramos Lavagnoli verfasserin aut Lindemberg da Mota Silveira Filho verfasserin aut Pedro Paulo Martins de Oliveira verfasserin aut Reinaldo Wilson Vieira verfasserin aut Domingo Marcolino Braile verfasserin aut In Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular, 2004 26(2011), 4, Seite 559-564 (DE-627)324824505 (DE-600)2031026-2 16789741 nnns volume:26 year:2011 number:4 pages:559-564 https://doi.org/10.5935/1678-9741.20110045 kostenfrei https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010 kostenfrei https://doaj.org/toc/0102-7638 Journal toc kostenfrei https://doaj.org/toc/1678-9741 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 26 2011 4 559-564
allfieldsSound	10.5935/1678-9741.20110045 doi (DE-627)DOAJ043104363 (DE-599)DOAJa6863fa259914e62932aecf1f5ad15e8 DE-627 ger DE-627 rakwb eng RD1-811 RC666-701 Elaine Soraya Barbosa de Oliveira Severino verfasserin aut Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation. Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis Surgery Diseases of the circulatory (Cardiovascular) system Orlando Petrucci verfasserin aut Karlos Alexandre de Souza Vilarinho verfasserin aut Carlos Fernando Ramos Lavagnoli verfasserin aut Lindemberg da Mota Silveira Filho verfasserin aut Pedro Paulo Martins de Oliveira verfasserin aut Reinaldo Wilson Vieira verfasserin aut Domingo Marcolino Braile verfasserin aut In Brazilian Journal of Cardiovascular Surgery Sociedade Brasileira de Cirurgia Cardiovascular, 2004 26(2011), 4, Seite 559-564 (DE-627)324824505 (DE-600)2031026-2 16789741 nnns volume:26 year:2011 number:4 pages:559-564 https://doi.org/10.5935/1678-9741.20110045 kostenfrei https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8 kostenfrei http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010 kostenfrei https://doaj.org/toc/0102-7638 Journal toc kostenfrei https://doaj.org/toc/1678-9741 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA AR 26 2011 4 559-564
language	English
source	In Brazilian Journal of Cardiovascular Surgery 26(2011), 4, Seite 559-564 volume:26 year:2011 number:4 pages:559-564
sourceStr	In Brazilian Journal of Cardiovascular Surgery 26(2011), 4, Seite 559-564 volume:26 year:2011 number:4 pages:559-564
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis Surgery Diseases of the circulatory (Cardiovascular) system
isfreeaccess_bool	true
container_title	Brazilian Journal of Cardiovascular Surgery
authorswithroles_txt_mv	Elaine Soraya Barbosa de Oliveira Severino @@aut@@ Orlando Petrucci @@aut@@ Karlos Alexandre de Souza Vilarinho @@aut@@ Carlos Fernando Ramos Lavagnoli @@aut@@ Lindemberg da Mota Silveira Filho @@aut@@ Pedro Paulo Martins de Oliveira @@aut@@ Reinaldo Wilson Vieira @@aut@@ Domingo Marcolino Braile @@aut@@
publishDateDaySort_date	2011-01-01T00:00:00Z
hierarchy_top_id	324824505
id	DOAJ043104363
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ043104363</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230502120121.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2011 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.5935/1678-9741.20110045</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ043104363</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJa6863fa259914e62932aecf1f5ad15e8</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD1-811</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC666-701</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Elaine Soraya Barbosa de Oliveira Severino</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2011</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. 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callnumber-first	R - Medicine
author	Elaine Soraya Barbosa de Oliveira Severino
spellingShingle	Elaine Soraya Barbosa de Oliveira Severino misc RD1-811 misc RC666-701 misc Valva mitral misc Prolapso da valva mitral misc Insuficiência da valva mitral misc Estenose da valva mitral misc Mitral valve misc Mitral valve prolapse misc Mitral valve insufficiency misc Mitral valve stenosis misc Surgery misc Diseases of the circulatory (Cardiovascular) system Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients
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topic_title	RD1-811 RC666-701 Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients Valva mitral Prolapso da valva mitral Insuficiência da valva mitral Estenose da valva mitral Mitral valve Mitral valve prolapse Mitral valve insufficiency Mitral valve stenosis
topic	misc RD1-811 misc RC666-701 misc Valva mitral misc Prolapso da valva mitral misc Insuficiência da valva mitral misc Estenose da valva mitral misc Mitral valve misc Mitral valve prolapse misc Mitral valve insufficiency misc Mitral valve stenosis misc Surgery misc Diseases of the circulatory (Cardiovascular) system
topic_unstemmed	misc RD1-811 misc RC666-701 misc Valva mitral misc Prolapso da valva mitral misc Insuficiência da valva mitral misc Estenose da valva mitral misc Mitral valve misc Mitral valve prolapse misc Mitral valve insufficiency misc Mitral valve stenosis misc Surgery misc Diseases of the circulatory (Cardiovascular) system
topic_browse	misc RD1-811 misc RC666-701 misc Valva mitral misc Prolapso da valva mitral misc Insuficiência da valva mitral misc Estenose da valva mitral misc Mitral valve misc Mitral valve prolapse misc Mitral valve insufficiency misc Mitral valve stenosis misc Surgery misc Diseases of the circulatory (Cardiovascular) system
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title	Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients
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title_full	Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients
author_sort	Elaine Soraya Barbosa de Oliveira Severino
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author_browse	Elaine Soraya Barbosa de Oliveira Severino Orlando Petrucci Karlos Alexandre de Souza Vilarinho Carlos Fernando Ramos Lavagnoli Lindemberg da Mota Silveira Filho Pedro Paulo Martins de Oliveira Reinaldo Wilson Vieira Domingo Marcolino Braile
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title_sort	resultados tardios da plastia mitral em pacientes reumáticos late outcomes of mitral repair in rheumatic patients
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title_auth	Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients
abstract	INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation.
abstractGer	INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation.
abstract_unstemmed	INTRODUÇÃO: Os resultados tardios da plastia mitral em pacientes reumáticos são controversos na literatura. OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation.
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title_short	Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients
url	https://doi.org/10.5935/1678-9741.20110045 https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8 http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010 https://doaj.org/toc/0102-7638 https://doaj.org/toc/1678-9741
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OBJETIVO: Estudo observacional e prospectivo que avalia os resultados tardios e identifica os fatores associados à reoperação e à mortalidade em pacientes reumáticos submetidos à plastia da valva mitral. MÉTODOS: Incluídos somente os pacientes com valvopatia mitral reumática submetidos a plastia, com insuficiência tricúspide associada ou não. Excluídos os pacientes com outros procedimentos associados. Um total de 104 pacientes foi estudado. Sobrevida e reoperação foram avaliadas pela analise de Kaplan-Meier e regressão logística de Cox. RESULTADOS: O tempo de seguimento foi de 63 ± 39 meses (IC 95% 36 a 74 meses). A classe funcional III e IV estava presente em 65,4% dos pacientes no pré-operatório. Foram realizadas 33 plastias do anel posterior, 21 comissurotomias, 50 comissurotomias e plastias do anel posterior. Não houve mortalidade operatória e a tardia foi de três (2,8%) pacientes. A reoperação tardia esteve associada à insuficiência mitral residual no pós-operatório (P<0,001), presença de hipertensão pulmonar no pré-operatório (P< 0,01), idade (P<0,04) e classe funcional no pós-operatório (P<0,001). No seguimento, a probabilidade de estar livre de reoperação com 5 e 10 anos foi de 91,2 ± 3,4% e 71,1 ± 9,2%, respectivamente. CONCLUSÃO: Os resultados tardios do reparo da valva mitral em pacientes reumáticos têm fatores associados à reoperação. O reparo da valva mitral reumática é seguro e com ótima sobrevida a longo prazo.<br<INTRODUCTION AND AIMS: The long-term results after surgical repair of rheumatic mitral valve remain controversial in literature. Our aim was to determine the predictive factors which impact the long-term results after isolated rheumatic mitral valve repair and to evaluate the effect of those factors on reoperation and late mortality. METHODS: One hundred and four patients with rheumatic valve disease who had undergone mitral valve repair with or without tricuspid valve annuloplasty were included. All patients with associated procedures were excluded. The predictive variables for reoperation were assessed with Cox regression and Kaplan Meier survival curves. RESULTS: The mean follow-up time was 63 ± 39 months (CI 95% 36 to 74 months). The functional class III and IV was observed in 65.4% of all patients. The posterior ring annuloplasty was performed in 33 cases, comissutoromy in 21 cases, and comissurotomy with posterior ring annuloplasty in 50 patients. There was no operative mortality. The late mortality was 2.8% (three patients). The late reoperation was associated with residual mitral valve regurgitation after surgery (P<0.001), pulmonary hypertension at the pre-operative time (P<0.001), age (P<0.04) and functional class at the post-operative time (P<0.001). We observed freedom from reoperation rates at 5 and 10 years of 91.2 ± 3.4% and 71.1 ± 9.2%, respectively. CONCLUSION: Repair of mitral valve in rheumatic valve disease is feasible with good long-term outcomes. Preoperative pulmonary hypertension, residual mitral valve regurgitation after surgery, age and functional class are predictors of late reoperation.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Valva mitral</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Prolapso da valva mitral</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Insuficiência da valva mitral</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Estenose da valva mitral</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Mitral valve</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Mitral valve prolapse</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Mitral valve insufficiency</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Mitral valve stenosis</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Surgery</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the circulatory (Cardiovascular) system</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Orlando Petrucci</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Karlos Alexandre de Souza Vilarinho</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Carlos Fernando Ramos Lavagnoli</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Lindemberg da Mota Silveira Filho</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Pedro Paulo Martins de Oliveira</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Reinaldo Wilson Vieira</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Domingo Marcolino Braile</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Brazilian Journal of Cardiovascular Surgery</subfield><subfield code="d">Sociedade Brasileira de Cirurgia Cardiovascular, 2004</subfield><subfield code="g">26(2011), 4, Seite 559-564</subfield><subfield code="w">(DE-627)324824505</subfield><subfield code="w">(DE-600)2031026-2</subfield><subfield code="x">16789741</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:26</subfield><subfield code="g">year:2011</subfield><subfield code="g">number:4</subfield><subfield code="g">pages:559-564</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.5935/1678-9741.20110045</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/a6863fa259914e62932aecf1f5ad15e8</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382011000400010</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/0102-7638</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/1678-9741</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SSG-OLC-PHA</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="d">26</subfield><subfield code="j">2011</subfield><subfield code="e">4</subfield><subfield code="h">559-564</subfield></datafield></record></collection>
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Resultados tardios da plastia mitral em pacientes reumáticos Late outcomes of mitral repair in rheumatic patients

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