Abstract
Aortic root dilatation with Manouguian-Seybold-Epting in combination with aortic valve replacement was performed
in 126 patients between 1998 and 2011 at the A.N. Bakulev SCCVS RAMS. Mean age of the patients was
12.4 ± 3.3 years. Before the operation 52 (41.3%) patients belonged to the II NYHA functional class, 62 (49.2%)
belonged to the III and 12 (9.5%) - to the IV class. Aortic valve stenosis manifested in 27 (21.4%) cases, aortic valve
insufficiency - in 1 (0.8%), combined aortic defect - in 98 (77.8%) of patients.
All the patients were operated under cardiopulmonary bypass (144.1 ± 37.6 min.), hypothermia 28°C and pharmacologic
cold cardioplegia. Median aortic cross-clamping time was 105.4 ± 24.4 min.
Hospital mortality rate was 4.8% (6 patients). Non-mortal hospital complications were revealed in 26 (20.6%) operated
on patients.
114 patients (90.5%) underwent implantation of adult-size prosthesis. Initial diameter of fibrous ring was
18.6 ± 2.2 mm on average, and diameter of prosthetic device was 22.8 ± 1.4 mm. Prosthetic devices of a smaller diameter
(17 and 19 mm) were implanted in 12 cases (9.6%) during Manouguian-Seybold-Epting surgery. Peak systolic
gradient between LV and Ao reduced significantly in comparison with its value before surgery (85.6 ± 37.5 mm Hg)
and was 20.4 ± 8.1 mm Hg, mean pressure gradient was 12.4 ± 8.6 mm Hg. Moderate mitral insufficiency (up to
grade 2) was noted in 23 (18.2%) patients during in-hospital period. Four patients (3.2%) had evident mitral insufficiency
of grade 3 and more. Subsequent replacement was performed in 2 cases and plasty - in 1 case.
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