| Journal: | Arquivos brasileiros de cardiologia |
| Database: | PERIÓDICA |
| System number: | 000289013 |
| ISSN: | 0066-782X |
| Authors: | Atik, Edmar1 |
| Institutions: | 1Clinica "Dr. Edmar Atik", Sao Paulo. Brasil |
| Year: | 2006 |
| Season: | May |
| Volumen: | 86 |
| Number: | 5 |
| Pages: | 378-381 |
| Country: | Brasil |
| Language: | Portugués, inglés |
| Document type: | Artículo |
| Approach: | Experimental |
| English abstract | OBJECTIVE: To determine the long-term natural history of patients with mild pulmonary valve stenosis METHODS: Throughout a 24-year evolutive period (1980 a 2004), 83 patients with pulmonary valve stenosis were evaluated, with 29 of them presenting a mild form of the defect. Of these 29, 13 patients had a long-term follow up. The mean age at the first and last follow-up visits was 34 months (1 month to 15 years) and 10.5 years (3 to 24 years), respectively. In addition to evolutive elements, those regarding clinical, electrocardiographic and echocardiographic aspects were also assessed. RESULTS: All patients remained assymptomatic throughout the study. Regarding the pulmonary valve pressure gradient, 5 (38.4%) presented a decrease, 3 (23%) remained unchanged, 4 (30.7%) presented elimination and 1 (7.6%) presented accentuation to a moderate degree of involvement. The mean initial and final gradient was 24.2 mmHg (15-30) and 13.6 mmHg (0-54), respectively. The initial gradients of the 4 patients who achieved spontaneous cure were 30, 19, 30 and 20 mmHg. The systolic murmur and right ventricular overload had a direct correlation to the gradient pressure degree, subdivided at each 10 mmHg. CONCLUSION: The spontaneous cure of the mild pulmonary valve stenosis is possible to achieve, similarly to other acyanogenic anomalies |
| Portuguese abstract | OBJETIVO: Determinar a evolução natural, a longo prazo, de pacientes com estenose pulmonar valvar discreta. MÉTODOS: No período evolutivo de 24 anos (1980 a 2004), foram avaliados 83 pacientes com estenose pulmonar valvar, sendo 29 destes em grau discreto. Destes 29, foram acompanhados, a longo prazo, 13 pacientes. A idade média na primeira e na última consulta correspondeu a 34 meses (1 mês a 15 anos) e 10,5 anos (3 a 24 anos), respectivamente. Avaliaram-se, como elementos evolutivos, os referentes à clínica, os aspectos eletrocardiográficos e os ecocardiográficos. RESULTADOS: Todos os pacientes mantiveram-se assintomáticos. Quanto ao gradiente de pressão valvar pulmonar, em 5 (38,4%) houve diminuição, manutenção em 3 (23%), eliminação em 4 (30,7%) e acentuação para grau moderado em 1 (7,6%). O gradiente médio inicial e final foi de 24,2 mmHg (15 a 30) e de 13,6 mmHg (0-54). Os gradientes iniciais dos 4 pacientes que obtiveram a cura espontânea eram de 30, 19, 30 e 20 mmHg. O sopro sistólico e a sobrecarga ventricular direita guardaram relação com o grau do gradiente de pressão, subdividido a cada 10 mmHg. CONCLUSÃO: A cura espontânea da estenose pulmonar valvar discreta é possível, de igual modo que ocorre em outras anomalias acianogênicas |
| Disciplines: | Medicina |
| Keyword: | Sistema cardiovascular, Válvulas, Pulmones, Estenosis, Cardiopatías congénitas, Historia natural |
| Keyword: | Medicine, Cardiovascular system, Stenosis, Valves, Lungs, Congenital cardiopathies, Natural history |
| Full text: | Texto completo (Ver HTML) |
