Remote Results after Mitral Valve Replacement

  • K. V. Pukas National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
DOI: https://doi.org/10.30702/10.30702/ujcvs/19.3712/070036-039
Keywords: mitral valve disease, arrhythmia, surgical rhythm’s renewal, cardio­pulmonary bypass

Abstract

Aim of investigation is to research properties of patients at remote period after mitral valve replacement (MVR). At ana-lyzed group are included 634 patients with mitral valve diseases, which were treated by MVR in National Amosov Institute of cardiovascular diseases from 1st January 2005 to 1st January 2007. Average being of research was 7.3 ± 0.9 years. Following values of research at 10-year step: survival 69.4%, stability of good results – 57.3%, freedom from thromboembolic events – 79.7%, freedom from reoperations – 95.4%. Plasty of LA was performed in 57 (10.1%) patients. Maze procedure was oc-cured in 39 (6.9%) patients. Concomitant tricuspid malformation (TV annuloplasty) was observed in 135 (23.7%) patients. Concomitant CABG was observed in 93 (5.0%) patients. Previous heart surgery (mainly closed mitral commissurotomy) had 129 (21.4%) patients. Reoperations were occured: thromboses (panus, paraprost. fistula) of mitral prostheses (n = 5), endocarditis (n = 3). AV blockade (pacemaker) was occured in 9 (1.6%) patients.

Best results of mitral valve replacement were observed in remote period in patients at II–III NYHA class with presence of sinus rhythm. Patients must be followed-up with tightly observation especially risk group–IV functional class, atrial fibrillation, concomitant tricuspid valve diseases, left atriomegaly (diameter of 6.0 cm or more), ejection fraction less than 0.45, high pulmonary hypertension (PASP > 70 mmHg), CABG + progressive ischemic heart disease, left ventriculomegaly (ESVI > 95 ml/mq), female, age more than 60 years.

Mitral valve replacement with operation Maze allows successfully renew sinus rhythm on a hospital stage, and stabilize it well during half-year after operation.

References

  1. Lazoryshynets VV, Knyshov GV, Popov VV. [Treatment of mitral valve disease complicated by atrial fibrillation]. Kyiv;2014. p.101. Russian.
  2. .Orlov VI, Murzabekova LI. [Cardiac surgery for patients with acquired heart valvular disease: long-term results and clini-cal factors influencing them]. Russian Journal of Cardiology. 2005;55(5):87–94. Russian.
  3. .Orlovskiі PI, Gritsenko VV, Vavilova TV, Kadinskaia MI, Petrishina TI, Mochalov OIu, et al. [Two approaches to cor-rection of disturbed hemostasis in patients with mechanical artificial heart valves at the long-term follow-up]. Vestn Khir Im I I Grek. 2004;163(5):20–4. Russian.
  4. American College of Cardiology; American Heart Asso-ciation Task Force on Practice Guidelines; Society of Car-diovascular Anesthesiologists, Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. J Am Coll Cardiol. 2006;48(3):e1–148. https://doi.org/10.1016/j.jacc.2006.05.021
  5. Butchart EG, Payne N, Li HH, Buchan K, Mandana K, Grunkemeier GL. Better anticoagulation control improves survival after valve replacement. J Thorac Cardiovasc Surg. 2002;123:715–23. https://doi.org/10.1067/mtc.2002.121162
  6. Stefanidis C, Nana AM, De Canniere D, Antoine M, Jansens J-L, Huynh, Le Clerc JL. 10-Year Experience With the ATS Mechanical Valve in the Mitral Position. Ann Thorac Surg. 2005;79:1934–8. https://doi.org/10.1016/j.athoracsur.2005.01.002
  7. Pribytkov MV. [Long-term results of simultaneous surgical correction of atrial fibrillation and rheumatic mitral valve disease [dissertation]. Moscow; 2004. Russian.
  8. Raskin VV. [Atrioplasty of the left atrium in patients with mi-tral heart disease [dissertation]. Moscow; 2006. Russian.
  9. . Rychin SV. [Maze procedure in the surgical treatment of atrial fibrillation in patients with mitral valve disease: evolu-tion of methods and results [dissertation]. Moscow; 2004. Russian.
  10. La Meir M. Surgical options for treatment of atrial fibrillation. Ann Cardiothorac Surg. 2014;3:30–7. https://doi.org/10.3978/j.issn.2225-319X.2014.01.07
  11. Avitall B, Kalinski A. Cryotherapy of cardiac arrhythmia: from basic science to the bedside. Heart Rhythm. 2015;12:2195–203. https://doi.org/10.1016/j.hrthm.2015.05.034
  12. Damiano RJ Jr, Badhwar V, Acker MA, Veeragandham RS, Kress DC, Robertson JO, Sundt TM. The CURE-AF trial: a prospective, multicenter trial of irrigated radiofrequency ablation for the treatment of persistent atrial fibrillation during concomitant cardiac surgery. Heart Rhythm. 2014;11:39–45. https://doi.org/10.1016/j.hrthm.2013.10.004
  13. Prabhu S, McLellan AJ, Walters TE, Sharma M, Voskoboinik A, Kistler PM. Atrial structure and function and its implications for current and emerging treatments for atrial fibrillation. Prog Cardiovasc Dis. 2015;58:152–67. https://doi.org/10.1016/j.pcad.2015.08.004
  14. Masoudi FA, Calkins H, Kavinsky CJ, Slotwiner DJ, Turi ZG, Drozda JP Jr, et al. 2015 ACC/HRS/SCAI left atrial appendage occlusion device societal overview: a professional societal overview from the American College of Cardiology, Heart Rhythm Society, and Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2015;86:791–807. https://doi.org/10.1002/ccd.26170
  15. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of the patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Assosiation Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64:e1–76. https://doi.org/10.1016/j.jacc.2014.03.022
Published
2020-01-07
How to Cite
1.
Pukas KV. Remote Results after Mitral Valve Replacement. ujcvs [Internet]. 2019Nov.7 [cited 2024Dec.21];(4 (37):36-9. Available from: http://cvs.org.ua/index.php/ujcvs/article/view/314
Issue
Ukrainian Journal of Cardiovascular Surgery No 4 (37) 2019
Section
ACQUIRED HEART DISEASES