Prognosis for Mitral Valve Repair Surgery in Functional Mitral Regurgitation.

PURPOSE: Our aim was to evaluate the development of new significant mitral regurgitation and long-term survival after mitral repair surgery in functional mitral regurgitation. METHODS: A retrospective observational analysis of the recurrence of functional mitral regurgitation (ischemic and nonischemic) and global mortality during follow-up of 176 patients who underwent mitral repair surgery between 1999 and 2018 in our center was conducted. RESULTS: The etiology of functional mitral regurgitation was ischemic in 55.7% of cases. After surgery, mitral regurgitation was 0-I in 92.3% of cases. We conducted a long-term clinical follow-up of a mean 42.2 months and an echocardiographic follow-up of a mean 41.8 months. We observed mitral regurgitation of at least grade II in 52 patients (36.9%). Survival at 1, 3, and 5 years was 78.8%, 66.7%, and 52.3%, respectively. Predictive factors for global mortality were age (hazard ratio = 1.038, p = 0.01) and a depressed preoperative ejection fraction. After a competing risk analysis, we found the only predictive factor for the recurrence of mitral regurgitation in our series to be age (sub-hazard ratio = 1.03, 95% confidence interval = 1.01-1.06, p = 0.016). CONCLUSION: Repair surgery for functional mitral regurgitation shows age as the only independent predictor of recurrence. Age and depressed ejection fraction were predictors of mortality.

La rehabilitación precoz en el enfermo con dano vácculo-encefálico en el servicio terapia intermedia / The precocious rehabilitation of patients with brain-vascular damage in the intermediate service

Foi realizado um estudo retrospectivo longitudinal comparativo dos doentes que ingressaram no Serviço de Terapia Intermediária do Hospital Clínico-Cirúrgico Docente Amália Simoni de Camaguey no período compreendido entre junho - dezembro de 1996 e janeiro - junho de 1997, todos com diagnóstico de doenças vasculo-encefálicas. Estes doentes foram divididos em dois grupos comparativos: os que ingressaram no segundo semestre de 1996 näo se submeteram a uma reabilitaçäo postural precoce, enquanto os que ingressaram no primeiro semestre de 1997 foram submetidos a estas técnicas, alcançando-se a reduçäo de complicaçöes atribuíveis a paciente acamado de forma substancial. A incidência de infecçäo pulmonar diminui em 14,5 por cento, assim como a incidência de úlcera de decúbito diminui em 11,9 por cento o que demonstrou o valor da reabilitaçäo postural precoce para este tipo de doente.