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PubMed1984

[Endomyocardial fibrosis or fibroplastic endocarditis. Indications and results of surgical treatment].

Endocardial fibrosis is most common in tropical regions where it affects young subjects. Fibroplastic endocarditis appears to be the same condition, seen in temperate countries. Fibrosis of the endocardium is the common lesion which initially involves the endocardium and not the myocardium. These lesions result in a restrictive and a valvular syndrome. The author recalls the signs of the right-sided, left-sided and bilateral forms of the disease. The signs in common to all forms are early diastolic endocardial vibration, arrhythmias and conduction disturbances and the possibility of endocardial calcifications. The disease progresses towards death within 3, 4 or 5 years after the discovery of the condition. Medical treatment is effective initially. Surgical treatment improves the prognosis, as demonstrated by the comparative study conducted in Abidjan between 30 operated patients and 31 non-operated patients. The most favourable forms are the isolated left-sided forms. However, surgery is indicated in all forms whenever there are signs of a restrictive syndrome or a moderate to severe mitral incompetence. The only definitive contra-indication at the present time is the presence of recurrent ascites with hepatic fibrosis.

Adolescent↗