Surgical treatment of mitral stenosis, complicated by massive thrombosis of the left atrium

Keywords: massive thrombosis of the left atrium; prosthesis of mitral valve; open mitral comissuroyomy; artificial blood circulation

Abstract

Objective. To analyze the peculiarities of surgical treatment of a mitral stenosis, complicated by massive thrombosis of left atrium.

Маterials and methods. The group analyzed, operated in the Institute, consisted of 344 patients. Thrombosis of left atrium was considered a massive, when thrombotic masses have occupied no less than one third of its volume, not mentioning an auricle of atrium.

Results. Hospital lethality after change of a mitral valve have constituted 4.2% and directly depended on from a degree of the left atrium thrombosis (р < 0.05). After open mitral comissurotomy hospital lethality was not observed, witnessing the expediency of the thrombosis matrix extraction.

Conclusion. During the operation for a massive thrombosis of left atrium it is important to remove a maternal base of thrombotic bed and to eliminate the left atrium auricle, what lowers essentially the risk for lethality and thromboembolic complications on a hospital stage. Doing preoperative computed tomography of head and abdominal organs constitutes obligatory condition for exclusion of a hidden thromboembolism occurrence.

Author Biography

V. V. Popov, Аmosov National Institute of Cardio-Vascular Surgery, Kyiv

Popov Volodymyr V. MD, PhD , Doc. Med. Sci.

Chief of Department of surgery of acquired heart disease

N.M.Amosov National Institute of Cardio-Vasculary surgery

6 N.M.Amosova str., 03680 Kyiv. Ukraine

https://amosovinstitute.org.ua

+ 38(044) 475-27-88, + 38(067)402-24-39

e-mail vladpopov@ukr.net

https://orcid.org/0000-0002-2851-5589

References

1. Knyshov GV, Bendet YaA. Priobretennye poroki serdca. Kiev; 1998. 312 s. [In Russian].
2. Knyshov GV, Popov VV, Mnishenko VI, Popova EV. Hirurgicheskoe lechenie mitralnogo stenoza, oslozhnennogo massivnym trombozom levogo predserdiya. Ukrainskiy kardiologicheskiy zhurnal. 2012; Dod. 1:162. [In Russian].
3. Popov VV. Protezirovanie mitralnogo klapana pri oslozhnennyh formah mitralnogo stenoza (kalcinoz, grubyy fibroz klapana, massivnyy tromboz levogo predserdiya) [avtoreferat dissertacii]. Kiev; 1988. 21 s. [In Russian].
4. Popov VV. Massivnyy tromboz levogo predserdiya pri mitralnom stenoze (osobennosti kliniki i profilaktiki trombembolicheskih oslozhneniy pri operaciyah s iskusstvennym krovoobrascheniem). Profilaktika, dispanserizaciya, diagnostika i lechenie serdechno-sosudistyh zabolevaniy. Riga; 1985; s. 244-5. [In Russian].
5. Popov VV, Mnishenko VI. Lechenie mitralnogo stenoza, oslozhnennogo massivnym trombozom levogo predserdiya. Tavricheskiy mediko-biologicheskiy vestnik. 2013;16(3,Ch.1):123-4. [In Russian].
6. Popov VV, Sytar LL, Mnishenko VI, Knyshov GV. Surgical treatment of isolated mitral valve disease complicated with massive thromboses of left atrium. 21th World Congress World Society of Cardio-Thoracic Surgeons. Berlin, Germany, 2011. The Heart Surgery Forum. 2011;14 (Suppl 2) : PE66. doi: 10.1532/HSF98.20111092.
7. Sitar LL, Popov VV. Hirurgicheskaya korrekciya mitralnogo stenoza, oslozhnennogo massivnym trombozom levogo predserdiya. Grudnaya hirurgiya. 1984;3:16-8. [In Russian].
8. Knyshov GV, Popov VV, Sytar LL, Mnishenko VI. Massive thrombosis of left atrium in surgery of isolated mitral valve disease: plasty or replacement? 60th ESCVS International congress (Moscow, Russia), 2011. Interact CardioVasc Torac Surg. 2011;12(Suppl 1): S1-S177. p. CP-167. doi: 10.1510/icvts.2011.0000S1.
9. Pukas KV, Popov VV, Lazorishinetz VV, Mnishenko VI, Topchiy A, Andrievskaya S. Saint Jude mechanical valve for isolated mitral valve disease complicated massive thromboses of left atrium. Controversies and Advancement in the Treatment of Cardiovascular Disease. The Fifteenthin the Series November 19 & 20, 2015; Montage Beverly Hills. Р.11.
10. Popov VV. Surgical treatment of isolated mitral valve disease complicated massive thromboses of left atrium. J Сardiovasc Surg. 2016;57(2, Suppl 2):33 (+ presentation). Available from: http://escvs2016.talkmc.net/upload /Attachment/File/2016_05/J_CARDIOVASC_SUPPL_2_AL_2_2016.pdf.
Published
2018-09-30
How to Cite
Popov, V. V. (2018). Surgical treatment of mitral stenosis, complicated by massive thrombosis of the left atrium. Klinicheskaia Khirurgiia, 85(9), 19-23. https://doi.org/10.26779/2522-1396.2018.09.19
Section
General Problems of Surgery