"Surgical remodeling of the heart" in multi-valvular diseases

Methods. There were executed 64 operations. Male – 15, female – 49, age 42,1 ± 11,7 years old. Mitral-triсuspid disease with enlarged Left Atrium – 33, Mitral-aortal-triсuspidal disease – 19, mitral-aortal-triсuspidal disease with enlarged LA-12. On MV there were following haemodynamic infringements: МS-34, Мitral regurgitation – 20, mitral restenosis – 10. On the aortal valve: АS-10, aortal disease without the accurate prevalence – 21. On the tricuspidal valve: combined tricuspidal stenosis with prevalence of insufficiency – 48, ТS-6. The term of «Surgical Remodeling of the Heart» we includ kinds of operations when 2 or 3 valves correction with left atrium reduction are done.

Results. Correction of 2valves with atrioplastic of LA is executed at 33,3 valves – at 19,3 valves with atrioplastic LA-12. 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 40 – multicomponent MV repeir with annuloplasty with a band from two layers of vascular graft. Aortal Valve reconstruction was done at 25 (by Carpentier – 22, by ElKhury-3), at 25 prosthetics of АV. Annuloplasty of tricuspid valve was done at 48 by DeVega, by Doty – 16, 24 cases were taken further TV comissuroplastic. At 45 patients were done LA atrioplastic with one-stage suturing of the LA appendage (by Kawazoe-31, by «Mercedes» – 12, by Sinatra – 1), suturing of LA appendage – 28, thrombectomy from LA-10. Time of CPB was 140,3 ± 35,5 min, cross-clamp time –105,8 ± 24,3 min. Hospital mortality – 1,5 % (n = 1).

Conclusions. Surgical remodeling at rheumatic multivalve heart diseases, including multicomponent correction 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.

ИНТРАОПЕРАЦИОННАЯ ОЦЕНКА КРОВОТОКА ПО КОРОНАРНЫМ ШУНТАМ МЕТОДОМ УЛЬТРАЗВУКОВОЙ ФЛОУМЕТРИИ

ВАСИЛЬЕВ В.П . , ШИРЯЕВ А.А., ГАЛЯУТДИНОВ Д.М., ЛАТЫПОВ Р.С., АНДРЕЕВ А.В., КУРБАНОВ С.К., МАЙОРОВ Г.Б., МУКИМОВ Ш.Д., АКЧУРИН Р.С.

ФГБУ НМИЦ кардиологии Минздрава РФ. Россия

Введение (цели/задачи). Оценить результаты интраоперационной флоуметрии коронарных шунтов у больных, перенесших прямую реваскуляризацию миокарда.

Материал и методы. В исследование вошли 126 пациентов, оперированных в ОССХ НМИЦ Кардиологии Минздрава РФ в 2018 году. Всем больным выполнялось коронарное шунтирование