Early surgical results in the treatment of endomyocardial fibrosis. A Brazilian cooperative study

• Published in: European journal of cardio-thoracic surgery Vol. 3; no. 5; pp. 408 - 413
• Main Authors: DA COSTA, F. D. A, MORAES, C. R, RODRIQUES, J. V, DE MENDONCA, J. T, DE ANDRADE, J. C, BUFFOLO, E, SUCCI, J. E, CARVALHO, R. G, FARACO, D. L, DA COSTA, I. A
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 1989; Elsevier Science
• Subjects: Adolescent; Adult; Arrhythmias, Cardiac - etiology; Biological and medical sciences; Bioprosthesis; Brazil; Cardiac Catheterization; Cardiac dysrhythmias; Cardiology. Vascular system; Child; Cineradiography; Echocardiography; Endomyocardial Fibrosis - pathology; Endomyocardial Fibrosis - physiopathology; Endomyocardial Fibrosis - surgery; Female; Heart; Heart Valve Prosthesis; Humans; Male; Medical sciences; Middle Aged; Mitral Valve - surgery; Multicenter Studies as Topic; Postoperative Complications; Thrombosis - surgery; Tricuspid Valve - surgery; Tropical medicine; Brazil; South America; Heart; Human; Cardiovascular disease; Replacement; Heart valve; Cardiac valvular disease; Surgery; America; Fibrosis; Brazil; Myocardium; Complication; Low cardiac output; Hemodynamics
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/1010-7940(89)90049-3

This report summarizes the surgical experience and early resultsobtained at four surgical centers in the northeast and south of Brazil.From December 1977 to September 1986, 95 operations were performed on 93patients, ages 11-59. Bilateral lesions occurred in 42 patients, rightlesions in 39, and left lesions in 12. Ventricular decortication andremoval of thrombi were performed in all. In right-sided lesions, thetricuspid valve was substituted by a bioprosthesis in 34 cases, andsubstituted by a tilting disk valve in 1 case. In 4 patients, the valvecould be preserved. The left-sided lesions led to valve substition by abioprosthesis in 11 cases, and preservation of the valve in 1. Thebilateral lesions needed bioprosthesis in the mitral position in 37patients, and a disk valve in 2. In these 39 instances, the valvularprocedure was insertion of a tricuspid bioprosthesis. Three tricuspid andthree mitral plasties were performed. The overall mortality was 20% (26.2%for bilateral lesions, 14.6% for the right-sided lesions, and 20% for theleft-sided lesions). The main cause of death was low cardiac output. Asidefrom a variable degree of right and left ventricular failure, many othernon-fatal complications clouded the postoperative course. Complete AVblocks occurred in 10 cases, with the need for permanent pacing in 7survivors. The mortality and morbidity in the present series is in keepingwith the results reported in current literature. Regarding the advancedstage of their patients' disease, the authors agree with the recommendationfor earlier surgical intervention.