Alexandre V BrickI; Antônio Augusto MianaI; Eloízio A ColenI; Pedro H. C PassosI; Ângela BorgesI; Paulo C JorgeI; Domingo M BraileII; Oswaldo T GrecoII; Roberto V ArditoII; José Luiz V SantosII; Rita de Cássia MayorquimII; Elizabete R LimaII; Marcos ZaiantchickII; Nelson L. K. L CamposII; Henri S GollarzaII; Dorotéia R. S SouzaII; Paulo Roberto BrofmanII; Danton R. da Rocha LouresIII; Roberto Gomes de CarvalhoIII; Edison José RibeiroIII
DOI: 10.1590/S0102-76381987000300006
ABSTRACT
A mitral pericardial bioprosthetic valve IMC-Biomedica was implanted in a consecutive series of 798 patients with mean age of 52 years, from December 1977 to November 1978. The 722 patients who survived operation were observed during a period of 9 years (mean 27036 months or 2253 years). Actuarial studies indicated an expected survived rate at 9 years of 66% for adult patients and 68% for younger patients. The probability of complications were the following: rupture 0.4; perivalvar leak 0.4%; thromboembolysm 2.7%; endocarditis 3.2%; calcification 4.4%. The actuarial freedom from calcification between 1977 to 1982 (Group I) was 94.0% to adults and 12.0% to younger patients. On the other hand, between 1982 to 1986 (Group II) the actuarial analysis of calcification showed that 99.0% adults and 92.0% younger patients were free from this complication. Hence we believe that our option for the pericardial bioprosthetic valve was appropriate because 96.0% patients were free of complications deaths with the valve; this means that in 9 years the bioprosthetic lethal potential was only 4.0%.RESUMO
De dezembro de 1977 a novembro de 1986, foi usado o bioenxerto valvular cardíaco de pericárdio bovino IMC-Biomédica na posição mitral, em 798 pacientes, com idade média de 42 anos. Os 722 pacientes sobreviventes foram observados por um período de até 9 anos, representando 27036 meses, ou 2253 anos. O estudo indicou um índice de sobrevida de 66% para os adultos e 69% para os jovens, sendo de 94% e 80% o índice de sobrevida para os adultos e jovens, respectivamente, com pós-operatório de 5 anos. A freqüência das complicações diante da amostra analisada foi: 0,4% de rotura do tecido; 0,4% de vazamento paravalvular; 2,7% de acidente vascular cerebral; 3,2% de endocardite infecciosa; 4,4% de calcificação. A curva atuarial de calcificação entre os anos de 1978 e 1982 (Grupo I) mostrou 94% dos adultos e 12% dos jovens livres dessa complicação. Por outro lado, de 1982 a 1986 (Grupo II), esse índice subiu para 99,0% entre os adultos e 92,0% para os jovens. Deste modo, concluímos que a nossa opção pela bioprótese de pericárdio bovino foi apropriada, visto que 96% dos pacientes estiveram livres de complicações fatais relacionadas à bioprótese, o que significa que, em 9 anos, o potencial da bioprótese foi apenas de 4%.REFERENCES
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