Dubost C, Chapelon C, Deloche A, Piette J C, Chauvaud S, Fabiani J N, Carpentier A
Service de médecine interne, hôpital Pitié-Salpêtrière, Paris.
Arch Mal Coeur Vaiss. 1990 Apr;83(4):481-6.
From 1971 to 1984, 32 patients with endomyocardial fibrosis (EMF) were treated by endocardial resection (decortication) and valve replacement. The population consisted in 20 men and 12 women (age ranged from 8 to 64); 19 patients were european and 13 african. All were symptomatic, 78 p. 100 in stages III or IV of the NYHA. Hypereosinophilia was detected in 21 patients and its cause was determined in 11 cases. Cardiac involvement was biventricular in 22 patients and monoventricular in 10 patients. Six patients died in the immediate postoperative period and 6 late deaths were observed, owing to extracardiac causes in 4. There were no recurrence of EMF. Despite a high mortality rate, the authors suggest that all symptomatic EMF should benefit from endocardial resection.
1971年至1984年期间,32例心内膜心肌纤维化(EMF)患者接受了心内膜切除术(剥脱术)和瓣膜置换术。患者包括20名男性和12名女性(年龄在8岁至64岁之间);19例为欧洲人,13例为非洲人。所有患者均有症状,78%处于纽约心脏协会(NYHA)心功能III或IV级。21例患者检测到嗜酸性粒细胞增多,其中11例确定了病因。22例患者心脏受累为双心室,10例为单心室。6例患者在术后短期内死亡,另有6例出现晚期死亡,其中4例死于心外原因。未观察到EMF复发。尽管死亡率较高,但作者认为所有有症状的EMF患者都应接受心内膜切除术。