| Revista: | Acta cirurgica brasileira |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000286060 |
| ISSN: | 0102-8650 |
| Autores: | Ferreira, Cesar Augusto1 Vicente, Walter Villela de Andrade Rodriguez, Alfredo Jose Campos, Antonio Dorival Silva-Junior, Jairo Rosa e Sarabanda, Alvaro Pyntia, Antonio Osvaldo |
| Instituciones: | 1Universidade de Sao Paulo, Faculdade de Medicina, Ribeirao Preto, Sao Paulo. Brasil |
| Año: | 2002 |
| Volumen: | 17 |
| Paginación: | 44-51 |
| País: | Brasil |
| Idioma: | Portugués |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico, analítico |
| Resumen en inglés | INTRODUCTION: The selection of the surgical approach to the mitral valve is a critical factor in obtaining good exposure and minimizing lesions of the surrounding structures. The classical right lateral subseptal access may sometimes provide difficult exposure, so that alternative approaches are used whose effects on atrial electrical activity are contradictory. OBJECTIVE:To standardize an investigative method to evaluate heart electrical activity post-op. METHODS: Ten consecutive adult patients with mitral valve disease were operated on. Surface electrocardiogram and continuous electrocardiographic monitoring (Holter system) pre and post-op., and epicardical cardioestimulation post-op. were used to study cardiac electric activity. RESULTS: There was no mortality. All patients with sinus rhythm presented supraventricular ectopia, with episodes of supraventricular tachycardia in 57%, atrial flutter in 10%, and junctional rhythm in 10%. All patients presented ventricular ectopia, with a low incidence in 70% of them and with unsustained ventricular tachycardia in 30%. During the postoperative period there was a 40% rate of new supraventricular arrhythmias (atrial fibrillation, junctional rhythm, low atrial rhythm, and paroxistic supraventricular tachycardia), with no ventricular arrhythmias. Post-op. sinus node function was preserved. There was a significant reduction of supraventricular ectopia, with reversal of atrial fibrillation to sinus rhythm in one patient. Although there was a significant reduction in left atrium size post-op, P wave duration, as well as ventricular ectopia rate remained unchanged. Interatrial conduction time correlated with left atrium size measured pre and post-op. CONCLUSION: The methods proved useful to evaluate atrial electric activity in patients operated upon by the classic subseptal access, thus permitting future comparisons with other surgical approaches to the mitral valve |
| Resumen en portugués | correlacionou-se com o tamanho do átrio esquerdo. CONCLUSÃO: A metodologia mostrou-se adequada e segura, e poderá ser empregada na comparação de diferentes incisões atriais para exposição valvar mitral |
| Disciplinas: | Medicina |
| Palabras clave: | Cirugía, Sistema cardiovascular, Conducción, Valvulopatías, Válvula mitral, Arritmias, Nodo sinusal, Actividad eléctrica |
| Keyword: | Medicine, Cardiovascular system, Surgery, Conduction, Mitral valve, Valvulopathies, Arrhythmias, Sinus node, Electrical activity |
| Texto completo: | Texto completo (Ver HTML) |
