Plástica da valva mitral em portadores de febre reumática

purpose: to analyze the late results of mitral valve repair in rheumatic patients. material and methods: between march 1980 and december 1997, 201 rheumatic patients underwent mitral valve repair in the heart institute of hcfmusp. average age was 26.9 ± 15.4 years and 59.6% were female. other diagnoses were present in 67.7% of patients and the most common was tricuspid regurgitation (31.3%). the techniques of repair were: carpentier ring annuloplasty in 75 (37.3%), posterior annuloplasty with pericardial sling in 68 (33.8%), posterior segmental annuloplasty in 16 (7.9%), quadrangular resection of the posterior leaflet in 11 (5.5%), partial resection of the anterior leaflet in 6 (3%), de vega type annuloplasty in 6 (3%), kay in 5 (2.5%), reed in 4 (2%) and others in 10 patients. associated techniques were employed in 94 patients (46.8%), the most frequent was chordal shortening (48 patients - 23.9%). associated procedures were performed in 113 patients (56.2%). the actuarial curves (kaplan-meier) were compared through linear regression analysis. results: hospital mortality was 4 patients (2.0%) and the causes were multiorgan failure in 2 (50%) and low cardiac output in 2 (50%). in the late postoperative period, 83.9% of the patients were in functional class i (nyha). the actuarial survival was 93.9 ± 1.9% in 125 months. twenty three patients were reoperated in the post-operative period with a mean interval of 35.7 months. the actuarial freedom from reoperation was 43.3 ± 13.7% in 125 months. comparing the patients according to age, in the group over 16 years (group 1), the actuarial survival was 91.3 ± 3.8%, against 95.6 ± 2.7% in the group with more than 16 years (group 2), with a statistic difference (p < 0.0001). freedom from reoperation was 50.8 ± 16.9% in group 1 and 47.0 ± 14.9% in group 2 (p < 0.0001). conclusions: late results with mitral valve repair in rheumatic mitral insufficiency were satisfactory.