BACKGROUND: Secondary @entity339 is a strong risk factor for @entity204 in end-stage @entity296 . The possible correction of @entity339 has now been accepted as an alternative to cardiac transplantation in a special subset of @entity1 . We propose a new surgical approach that consists of implantation of a mitral prosthesis that is smaller than the annulus, and preservation and traction of the papillary muscles to reduce sphericity of the left ventricle. METHODS: Between December 1995 and September 2005, 116 @entity1 with @entity384 underwent this procedure, with the following etiologic factors: ischemic (68), idiopathic (43), @entity1526 (3), viral (1), and postpartum (1). The @entity1 were analyzed according to clinical criteria, echocardiographic findings, and morphology of left ventricle. RESULTS: All @entity1 were in an end-stage phase, requiring >2 hospital admissions over the past 3 months, despite receiving full medication. Furthermore, seven were in intensive care unit receiving intravenous drugs or intra-aortic balloon counterpulsation, and one was in @entity1455 . Hospital mortality was 16.3% (19/116), yet midterm follow-up showed a relatively flat late survival curve, with evidence of improved clinical status, better echocardiographic parameters, and reduction in ventricular sphericity. CONCLUSIONS: The high early mortality rate related to other clinical conditions at the time of surgery. However, the resultant flat survival after this early interval offers a promising long-term therapeutic alternative for the treatment of @entity1 in @entity712 with @entity296 that is associated with moderate or severe secondary @entity339 .

End-stage XXXX and secondary @entity339 surgical alternative with prosthesis implant and left ventricular restoration.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1455 :: ('MESH:D012770', 'Disease') :: ['cardiogenic shock'] @entity296 :: ('MESH:D009202', 'Disease') :: ['cardiomyopathy'] @entity339 :: ('MESH:D008944', 'Disease') :: ['mitral regurgitation', 'mitral insufficiency'] @entity712 :: ('MESH:D006333', 'Disease') :: ['refractory heart failure'] @entity384 :: ('MESH:D002311', 'Disease') :: ['dilated cardiomyopathy'] @entity1526 :: ('MESH:D014355', 'Disease') :: ['Chagas disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity296 :: (MESH:D009202,Disease) :: ['cardiomyopathy']
