Remote results after mitral valve replacement

  • K. V. Pukas National M. M. Amosov Institute of Cardiovascular Surgery National Academy of Medical Sciences of Ukraine (Kyiv)
  • V. V. Lazorishinetz National M. M. Amosov Institute of Cardiovascular Surgery National Academy of Medical Sciences of Ukraine (Kyiv)
Keywords: mitral valve disease, arrhythmia, surgical rhythm’s renewal, cardio-pulmonary bypass


Aim of investigation is to research properties of patients at remote period after mitral valve replacement (MVR). At analyzed group are included 634 patients with mitral valve diseases, which were treated by MVR in National Institute of cardio-vascular diseases named after Amosov from 1 st January 2005 to 1 st January 2007. Average being of research was 7,3±0,9 yy. Following values of research at 10 year step: survival 69,4%, stability of good results – 57,3%, freedom from trombembolic events – 79,7%, freedom from reoperations – 95,4%. Plasty of LA was perfomed in 57 (10,1%) patients. Maze procedure was occured 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: thomboses (panus, paraprost. fistula) of mitral prostheses (n=5), endocardytis (n=3). A-V blocade (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 titghly observation especially risk group – IV functional class, atrial fibrillation, concominant tricuspid valve diseases, left atriomegaly (diameter of 6.0 cm or more), ejection fraction less than 0.45, high pulmonary hypertension (PSPPA>70 mmHg), CABG + progressive ischemic heart disease, left ventriculomegaly (ESVI >95 ml/m.q), female, age more than 60 year.

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


1. Lazorishinec VV, Knyshov GV, Popov VV. Lechenie mitralnyh porokov serdca, oslozhnennyh fibrillyaciey predserdiy. Kiev; 2014. 101 s. (in Russian)

2. Orlov VI, Muzarbekova LI. Kardiohirurgicheskoe lechenie pacientov s priobretennymi porokami serdca: otdalennye rezultaty i klinicheskie faktory, vliyayuschie na nih. Ros. kardiol. zh. 2005:55(5):87-93. (in Russian)

3. Orlovskiy PI, Gricenko VV, Vavilova TV, i dr. Dva podhoda k korrekcii narusheniy gemostaza u bolnyh s mehanicheskimi iskusstvennymi klapanami serdca v otdalennye sroki nablyudeniya. Vestn. hirurgii. 2004;163(5):20-4. (in Russian)

4. Pribytkov MV. Otdalennye rezultaty odnomomentnoy hirurgicheskoy korrekcii fibrillyacii predserdiy i revmaticheskogo mitralnogo poroka [dissertaciya]. Moskva; 2004. 231 s. (in Russian)

5. Raskin VV. Atrioplastika levogo predserdiya u bolnyh s mitralnym porokom serdca [dissertaciya]. Moskva; 2006. 275 s. (in Russian)

6. Rychin SV. Operaciya “labirint” pri hirurgicheskom lechenii fibrillyacii predserdiy u bolnyh s porokom mitralnogo klapana: evolyuciya metodov i rezultaty [dissertaciya]. Moskva; 2004. 295 s. (in Russian)

7. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. J Am Coll Cardiol. 2006;48(3):733-812.

8. Avitall B, Kalinski A. Cryotherapy of cardiac arrhythmia: from basic science to the bedside. Heart Rhythm. 2015;12:2195-203.

9. Butchart EG, Payne N, Li HH, et al. Better anticoagulant controll improves survival after valve replacement. J Thorac Cardiovasc Surg. 2002;123:715-23.

10. Damiano RJ, Badhwar V, Acker MA, et al. 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.

11. January CT, Wann LS, Alpert JS, 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.

12. La Meir M. Surgical options for treatment of atrial fibrillation. Ann Cardiothorac Surg. 2014;3:30-7.

13. Masoudi FA, Calkins H, Kavinsky CJ, 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.

14. 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.

15. Stefanidis C, Nana AM, De Canniere D, Antoine M, Jansens J-L, Huynh, et al. 10-Year Experience With the ATS Mechanical Valve in the Mitral Position. Ann Thorac Surg. 2005;79:1934-8.

16. La Meir M. Surgical options for treatment of atrial fibrillation. Ann Cardiothorac Surg. 2014;3:30-7.
How to Cite
Pukas, K. V., & Lazorishinetz, V. V. (2018). Remote results after mitral valve replacement. Ukrainian Journal of Cardiovascular Surgery, (3 (32), 44-47.