Surgical Remodeling of the Heart in Valvular Diseases

Abstract

Objective: The purpose is to present results of surgical remodeling of rheumatic multivalve heart diseases. Methods: There were executed 82 operations. Male-17, female-65, age 43.1±11.7 years old. Mitral-triсuspid disease with enlarged Left Atrium-34, Mitral-aortal-triсuspidal disease-31, mitral-aortal-triсuspidal disease with enlarged LA -17. On MV, there were the following haemodynamic infringements: МS-44, Мitral regurgitation-28, mitral restenosis-10. On the aortal valve: АS-26, aortal disease without the accurate prevalence-22. On the tricuspid valve: combined tricuspidal stenosis with prevalence of insufficiency-45, ТS-6. In the term “Surgical Remodeling of the Heart” we included kinds of operations when 2 or 3 valves correction with left atrium reduction are done. Results: Correction of 2 valves with atrioplastic of LA is executed at 33, 3 valves-at 31, 3 valves with atrioplastic LA-18. At correction of a pathology of valves following kinds of interventions are executed. There were done 24 MV prosthetics with preservation of MV basic chords, at 58- multicomponent MV repair with annuloplasty with a band from two layers of vascular graft. Aortal Valve reconstruction was done at 23 (by Carpentier-20, by ElKhury-3), at 25 prosthetics of АV. Annuloplasty of tricuspid valve was done at 42 by DeVega, by Doty-16, 24 cases were taken further TV comissuroplastic. At 51 patients were done LA atrioplastic with one-stage suturing of the LA appendage (by Kawazoe-36, by “Mercedes”-14, by Sinatra-1), suturing of LA appendage-41, thrombectomy from LA-10. Time of CPB was 147.3± 35.7 min, cross-clamp time-107.8±24.4 min. Hospital mortality - 1.5 % (n=1). Conclusions: Surgical remodeling of rheumatic multivalve heart diseases, including multicomponent correction of 2 and 3 valves in a combination to one of reduction methods at left atrial, allows to restore normal functional indicators of heart with good nearest results.