Abstract
Introduction. Moderate or severe mitral valve insufficiency after radical correction of complete atrioventricular canal (CAVC) defect
occurs in 30-50% of cases and 7-23% of patients require repeated surgery. Failure to carry out plastic procedure often leads to valve
replacement. In this regard, to make a decision about the possibility of restoring normal structural and functional relationships of
mitral valve components is necessary their morphometric evaluation in patients undergoing radical CAVC correction and comparison with the corresponding parameters of the normal heart.
Material and methods. The morphological study of 30 children hearts at the age from 43 days to 36 months (mean to 15.1 ± 3.2
months) died after radical correction of CAVC were analyzed. As the control group were studied 30 children hearts of the appropriate age, died of causes unrelated to diseases of the cardiovascular system.
Results. In patients after CAVC correction in the age group 0-6 months was observed moderate dilatation of mitral valve annulus,
and in the age groups 7-12 months and 12-36 months - moderate hypoplasia of mitral valve annulus compared with the control.
The surface area of the mitral leaflets was 2.3-2.4 times larger than the mitral annulus in all groups after CAVC correction. But myxomatous
mitral valve tissue did not possess the necessary mechanical and elastic properties, that lead to systolic prolapse of mitral
leaflets into the left atrial cavity. Myxomatous changes in mitral valve tissue structure were the cause of the suture eruption on the
newly created fibrous ring and the front mitral leaflet. In patients after CAVC correction changes in the subvalvular tendon-muscle
structures were found. These changes have led to the development of mitral valve failure in the postoperative period.
Conclusion. The cause of mitral valve insufficiency in infants in the postoperative period after CAVC correction is a connective tissue
dysplasia of the leaflets and subvalvular chordal-muscular valve apparatus.
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