Abstract
Objective. Study the results of valve-preserving interventions in mitral defects in children, depending on the initial anatomic and hemodynamic features.
Material and methods. In this report the experience of surgical treatment of 29 patients from November 2009 to February 2016 at the Federal Center of Cardiovascular Surgery (Penza) performed the reconstructive surgery on the mitral valve. Depending on the anatomical and hemodynamic characteristics of the mitral lesions were allocated to 2 groups. The first group consisted of patients with a predominance of mitral insufficiency (n=15), the second – with a predominance of mitral stenosis (n=14).
Results. Typical changes in the first group were the shortage of tissue folds with the expansion of the annulus, whereas in the second group – the presence of “parachuteing” mitral valve. In the early postoperative period died 2 (6.9%) patients. In the long term died in 1 (3.4%) patient in the group with a predominance of mitral stenosis. Re-intervention was required 1 (3.4%) patients from the group with a predominance of mitral regurgitation in the early postoperative period and 1 (3.4%) patient of the group with a predominance of mitral stenosis in the late postoperative period. Revealed that patients with a predominance of mitral valve stenosis require surgical intervention at an earlier age due to the rapid progression of symptoms of heart failure and development of pulmonary hypertension.
Conclusion. Overall, the reconstructive surgery on the mitral valve accompanied by a satisfactory long-term results, regardless of the original anatomical and hemodynamic features and other associated complex cardiac anomalies. In terms of supervision of up to 6 years old remote probability of survival was 89.1± 0.6 percent. Freedom from cardiac events for 6 years was 91.4±0.6%.
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About the authors
- Chernogrivov Aleksey Evgen'evich, Dr Med. Sc., Cardiovascular Surgeon, Head of Department, orcid.org/0000-0002-6207-4799;
- Talysheva Oksana Nikolaevna, Pediatrician, Ultrasonic Diagnostics Physician, orcid.org/0000-0001-7243-8923;
- Vostokova Ekaterina Valer'evna, Pediatrician, orcid.org/0000-0002-9458-9180;
- Chernogrivov Igor' Evgen'evich, Dr Med. Sc., Cardiovascular Surgeon, orcid.org/0000-0002-6619-3875;
- Suleymanov Shakhriyar Fazailovich, Anesthesiologist-Intensivist;
- Bofanov Dmitriy Alekseevich, Cardiovascular Surgeon, orcid.org/0000-0003-0492-8845;
- Bazylev Vladlen Vladlenovich, Dr Med. Sc., Professor, Chief Physician, orcid.org/0000-0001-6089-9722
