Abstract 12465: Surgical Outcomes of Patients With Endomyocardial Fibrosis Operated at the Heart Institute in Mozambique

Introduction: Endomyocardial fibrosis (EMF) is a myocardiopathy that results from restriction of the ventricular filling caused by the presence of fibrous tissue in the endocardium. It is estimated that this disease affects approximately 12 millions of people worldwide and most of these people are in the Sub-Saharan Africa. Until today there is no consensus regarding the best therapeutic approach in these patients, but there are reports of encouraging results in patients treated surgically. Objective: To describe the results of surgical treatment of patients with EMF and the factors that influence it. Methodology: 86 patients with EMF were operated at Instituto do Coração (Heart Institute) in Mozambique, between 2002 and 2017. Results: Most of the patients were male (61.6%) with ages between 3 and 39 years (mean, 12 years). Forty-three per cent (43%) of the patients were coming from the province of Inhambane and 81.4% of them had biventricular disease. Sixty-two per cent (62%) of the patients were in functional classes III/IV of New York Heart Association (NYHA) . After the surgery, most of the operated patients (70.9%) had improvement in the NYHA functional class. The post-operatory mortality was 6.9% and mainly related to heart failure. The cumulative mortality after 12, 24 and 60 months was 5.7%, 7.7% e 23.5% respectively. The survival after 5 years was estimated around 76.5%. Conclusion: Apart from an elevated post-operatory and cumulative mortality, EMF surgery can significantly improve the patients’ functional class and survival, so it can be considered a valid alternative to patients with EMF who present in advanced stages of the disease (NYHA functional classes III and IV).