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[Endomyocardial fibrosis. Course in patients undergoing clinical and surgical treatment]
C Mady1, A C Barretto, S A de Oliveira
1Instituto do Coração do Hospital das Clínicas, FMUSP.
Purpose:
To follow-up a group of patients during a period of time after either clinical or surgical approach.
Patients And Methods:
A hundred and twenty-one patients were studied retrospectively with endomyocardial fibrosis (EMF) for a period that varied from one month to 11 years (mean = 32 months). Upon entrance, patients had from 5 to 64 years of age (mean = 30), being 41 male and 80 female. Biventricular involvement were present in 70 cases, whereas 36 showed pure left and 15 pure right ventricular involvement. The patients were divided in two groups: 62 treated clinically, and 59 surgically, the latest defined as fibrosis resection added to atrioventricular valve rebuilding or replacement. All surgical cases had a prior III to IV functional class (NYHA).
Results:
In the clinical group there were 24 fatalities, 21 who were in class IV, 1 in class III, and 2 in class II. In the surgical group there were 18 fatalities, 12 early and 6 late.
Conclusions:
(1) All the patients who survived the operation showed functional class improvement; (2) surgical mortality decreased in the latest years; (3) clinical treatment is indicated to patients in classes I and II, groups with low mortality rates; (4) surgical treatment is indicated to patients in classes III and IV, provided that clinical mortality is high in these groups of patients.