Idiopathic dilared cardiomyopathy mitral regurgitation correcction

pp. 168-173

Abstract

Objective

Mitral regurgitation is a frequent complication of idiopathic dilated cardiomyopathy that contributes to a poor survival. We studied the surgical correction in the mitral insufficency in eight patients with cardiac failure refractory to optimized medical treatments. 

Material and methods

Theses patients had an average age of 48 ± 12 years old, belonged to funcional calss of III-IV NYHA and left ventricular ejection fraction of 20.3 ± 4.4%. Mean number of hospitalizations during the previous years had bee 2-4 times. Operatively all 8 patients had subvalvular apparatus repair and concomitant replacement with mechanical bileaflet valve, in a "hybrid" technique. 

Results

Neither operative deaths occurredm nor deaths were registered during hospitalization or follow-up of 13.4±11.7 months. Significantly New York Heart Association class improve frome 3.2±0.5 before the operation to 1.4±0.5 (p<0.0001) after it. Both the ejection fraction and the peak oxygen consumption increased. 

Conclusions

These patients, despite being a high-risk population, improved their functional status remarkably. Mitral valve reconstruction for idiopathic dilated cardiomyopathy with mitral regurgitation stands as a new therapeutic strategy for patients with end-stage heart failure.