MP50. Reconstruction of Left Part of The Heart for Combined Mitral-Aortic Valve Diseases
Presented During: Moderated E-Posters
National Institute of cardio-vascular surgery named after Amosov
Kiev, Kiev
Ukraine - Contact Me
Dr. Popov Volodymyr, MD, PhD, Doctor of Medical Sciences, Professor.
Chief of department of surgery of acquired heart disease
Amosov National Institute of Cardiovascular Surgery
6, Mykoly Amosova St, Kyiv, 02000 Ukraine
mob. +380 67 402 24 39,
[email protected], www.vladpopov.kiev.ua
Thursday, May 4, 2023: 6:30 PM - Saturday, May 6, 2023: 2:29 AM
New York Hilton Midtown
Room: Grand Ballroom Foyer
Description
OBJECTIVE. To determined possibillities of correction of the left parts of the heart by preservation of MV`s apparatus and concomitant reduction of left atrium (LA) during correction of combined mitral-aortic valve diseases (CMAVD).
METHODS. During 01.01.2006-01.01.2020 yy. 201 adult patients (pts) were operated with CMAVD, giant diameter of LA (diameter 60 mm and more) and concomitant left ventriculomegaly (left ventricle`s end-diastolic volume 300 ml and more) at Institute. Average age was 57,2± 10,6 yy. 171 (85,1%) pts were in IY NYHA class and 30 (14,9%) in III class. All material divided at 2 groups: group A (n= 82): AVR + LA`s plasty (all pts) + MVR with preservation of posterior leaflet (all pts) and additionally translocation of anterior leaflet`s papillary muscles (n=54); group B (control group) (n= 119): only MAVR without preservation of MV`s structure and without LA`s plasty. In both groups concomitant procedures were occured on reconstruction of the annuli of narrow ostium of aorta (n =5), tricuspid valve`s plasty (n = 47), CABG (n =21).
RESULTS. There were 3 deaths at the hospital period (hospital mortality (HM) - 3,6%) (group A). At the remote period (average was 9,3± 1,8 yy) 75 pts were followed –up. Sinus rhythm was preserved at 11 (14,7%) pts and there were 3 deaths . Unsatisfactive results were marked: myocardial infarction (n=2), thromboembolic event (n=1).
Data of echo for group A: end-systolic volume index (ESVI) (ml/m.sq.) - preoperative 78,8 ± 13,5, postoperative (6 -11 dd) - 59,8 ± 9,1 and at the remote period 49,6 ± 7,2 and diameter of LA (mm) preoperative - 63,4 ± 5,2, postoperative - 49,4 ±4,2, remote period - 51,8 ± 3,3.
There were 6 deaths at the hospital period (HM - 5,0%) (group B). At the remote period (average was 8,1± 1,5 yy) 99 pts were followed –up. Data of echo for group B: ESVI - preoperative 81,8 ± 12,2, postoperative (6 -11 dd) - 70,6 ± 13,4 and remote period 61,4 ± 9,2 and diameter of LA (mm) preoperative - 64,5 ± 5,2, postoperative - 62,4 ± 6,7, remote period – 74,1 ± 5,6. Sinus rhythm wasn`t marked in any pts and there were 13 deaths. Unsatisfactive results were marked: progressive heart failure(n=8), thromboembolic events (n=4).
CONCLUSION. Reconstruction of the left part of the heart for CAMVD by preservation of MV and LA`s plasty during MAVR was allowing to improve indixes of LV`s and LA`s morphometry, contractility during early and at the remote period comparing with gro
METHODS. During 01.01.2006-01.01.2020 yy. 201 adult patients (pts) were operated with CMAVD, giant diameter of LA (diameter 60 mm and more) and concomitant left ventriculomegaly (left ventricle`s end-diastolic volume 300 ml and more) at Institute. Average age was 57,2± 10,6 yy. 171 (85,1%) pts were in IY NYHA class and 30 (14,9%) in III class. All material divided at 2 groups: group A (n= 82): AVR + LA`s plasty (all pts) + MVR with preservation of posterior leaflet (all pts) and additionally translocation of anterior leaflet`s papillary muscles (n=54); group B (control group) (n= 119): only MAVR without preservation of MV`s structure and without LA`s plasty. In both groups concomitant procedures were occured on reconstruction of the annuli of narrow ostium of aorta (n =5), tricuspid valve`s plasty (n = 47), CABG (n =21).
RESULTS. There were 3 deaths at the hospital period (hospital mortality (HM) - 3,6%) (group A). At the remote period (average was 9,3± 1,8 yy) 75 pts were followed –up. Sinus rhythm was preserved at 11 (14,7%) pts and there were 3 deaths . Unsatisfactive results were marked: myocardial infarction (n=2), thromboembolic event (n=1).
Data of echo for group A: end-systolic volume index (ESVI) (ml/m.sq.) - preoperative 78,8 ± 13,5, postoperative (6 -11 dd) - 59,8 ± 9,1 and at the remote period 49,6 ± 7,2 and diameter of LA (mm) preoperative - 63,4 ± 5,2, postoperative - 49,4 ±4,2, remote period - 51,8 ± 3,3.
There were 6 deaths at the hospital period (HM - 5,0%) (group B). At the remote period (average was 8,1± 1,5 yy) 99 pts were followed –up. Data of echo for group B: ESVI - preoperative 81,8 ± 12,2, postoperative (6 -11 dd) - 70,6 ± 13,4 and remote period 61,4 ± 9,2 and diameter of LA (mm) preoperative - 64,5 ± 5,2, postoperative - 62,4 ± 6,7, remote period – 74,1 ± 5,6. Sinus rhythm wasn`t marked in any pts and there were 13 deaths. Unsatisfactive results were marked: progressive heart failure(n=8), thromboembolic events (n=4).
CONCLUSION. Reconstruction of the left part of the heart for CAMVD by preservation of MV and LA`s plasty during MAVR was allowing to improve indixes of LV`s and LA`s morphometry, contractility during early and at the remote period comparing with gro