СРАВНЕНИЕ ГЕМОДИНАМИЧЕСКИХ ПАРАМЕТРОВ И ОТДАЛЕННОГО ПРОГНОЗА У ПАЦИЕНТОВ ПОСЛЕ АОРТАЛЬНОГО ПРОТЕЗИРОВАНИЯ ИСКУССТВЕННЫМИ КЛАПАНАМИ СЕРДЦА «ПЛАНИКС-Э» И ЗАРУБЕЖНЫМИ АНАЛОГАМИ

Abstract

The article presents the results of aortic valve replacement with artificial prosthetic heart valves. The study comprised 422 patients after aortic valve replacement with mechanical bicuspid valve prostheses of 19, 21, and 23 mm. The valves used were «Planiks-E», MedIng-2, Carbomedics, ATS Medtronic, St. Jude Medical. Hospital and long-term results are analyzed directly depending on the type-size of the AMHV used. There was a significant decrease in the peak and average transvalvular gradient on the all aortic valves (p < 0.0015), as well as an increase in the effective orifice area (EOA) of the aortic valve. EOA of the prosthesis “Planiks E” was not significantly different from that of its foreign equivalents. The EOA of St.Jude Medical prostheses was significantly larger compared to the Sorin Carbomedics prostheses (p > 0.005). The peak and mean gradients were different significantly (p = 0.007 and p < 0.05). The highest maximum systolic gradient was observed with Sorin Carbomedics prostheses. The phenomenon of prosthesis-patient mismatch of moderate degree in the early postoperative period was observed in 30.3% of patients, and in 4.1% it was severe. For “Planiks-E” prostheses, severe PPM was observed in 3.2% of patients. “Planiks-E” and ATS Medtronic prostheses were less common related to moderate PPM, in 27.80% and 28.60% correspondently. Overall hospital mortality was 3.4%. The risk of developing moderate PPN was 1.66 (95% CI 1.087 – 2.539, p = 0.19). The follow-up period mediana was 3.4 (2.12÷5.93) years. There were no significant differences in survival between patients without or with different PPM degrees (log-rank test, p = 0.539). Among “Planiks-E” the five-year survival rate was 87%.The PPN phenomenon did not significantly affect long-term survival. The heart valve prosthesis “Planiks-E” is comparable in its hemodynamic parameters to similar imported prostheses, the risk of moderate PPN being significantly lower.