Abstract
The article exhibits a new approach for the orifice deficiency rate to be assessed between the annulus of a normal heart valve and the internal orifice of the HVMP (heart valve mechanical prosthesis) when implanted in children and adolescents. The retrospective study of the orifice deficiency values was performed for the patient cohort underwent AVR (128 pts) at the Bakulev Research Center for Cardio-Vascular Surgery RAMS from 2000 to 2006. Quantitative assessment of the patients orifice deficiency values depending on their age and somatic growth has been done according to a new designed calculation protocol. The key criterion of the protocol is the Z-score value of implanted prosthesis that is the ratio between the HVMP internal orifice diameter (provided by manufacturers) and a normal childs heart valve annulus diameter (taken from morphometry database for normal non-fixed hearts). The analysis findings demonstrated that «size reserve» quality of selected prosthesis was achieved in 21% of patients after aortic valve replacements. Differences in labeled and geometric sizes of mechanical prostheses require a mandatory preclinical calculation of the orifice deficiency values for the optimum prosthesis to be selected. Both the calculation protocol and prosthesis selection criterion give an opportunity to select the appropriate size and type of prosthesis before surgery to prevent the risk of patient prosthesis mismatch development soon after the intervention.
References
Работа выполнена в рамках госконтракта с Роснаукой от 9 апреля 2007 г. № 02.512.11.2091.
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