The arch-like plasty of the left atrium in correction of a mitral valve failure

Keywords: dilatation of left atrium; аrch-like plasty of left atrium; prosthesis of mitral valve; plasty of mitral valve; artificial blood circulation.

Abstract

Objective. Studying the possibilities of the method of the left atrium arch-like plasty while correcting of a mitral failure in combination with the left atrium dilatation.

Materials and methods. Into the analysis of the surgical treatment results in 190 patients, suffering mitral failure in combination with the left atrium dilatation, who were operated in the National Institute of Cardio-Vascular Surgery named after N. M. Amosov NAMS of Ukraine in a period from 01.01.2012 to 01.01.2021 yr, were included. The main group consisted of 103 patients, to whom correction of a mitral failure in combination with original procedure of the arch-like plasty of left atrium was performed. Into a control group 87 patients were included, to whom the correction of a mitral valve failure was done without concomitant plasty of left atrium.

Results. Of 103 operated patients of the main group on the hospital stage 1 have died (0.9% lethality). Dynamics of echocardiographic indices on the treatment stages was following: definitely-systolic index of the left ventricle - (63.1 ± 11.3) ml/m2 (preoperatively), (58.3 ± 8.4) ml/m2 (postoperatively), (49.4 ± 9.2) ml/m2 (remote period); the left ventricle ejection fraction: 0.52 ± 0.04 (preoperatively), 0.55 ± 0.04 (postoperatively), 0.57 ± 0.03 (remote period). Diameter of left atrium: (58.8 ± 6.4) mm (preoperatively), (41.4 ± 5.3) mm (postoperatively), (43.9 ± 2.3) mm (remote period). Sinus rhythm in a remote period was stable in 75 (78.9%) of 95 patients. Of 87 operated patients of a control group 2 died (lethality 2.3%). Dynamics of the echocardiographic indices on the treatment stages was following: definitely-systolic index of left ventricle- (67.3 ± 11.3) ml/m2 (preoperatively), (60.4 ± 9.3) ml/m2 (postoperatively), (52.7 ± 7.2) ml/m2 (remote period); the left ventricle ejection fraction: 0.52 ± 0.05 (preoperatively), 0.54 ± 0.05 (postoperatively), 0.54 ± 0.03 (remote period). Diameter of left atrium: (59.5 ± 2.3) mm (preoperatively), (57.5 ± 3.7) mm (postoperatively), (68.5 ± 3.4) mm (in remote period). Sinus rhythm was stable in 18 (22.5%) of 80 patients, followed in the remote period.

Conclusion. The arch-like plasty of left atrium is a low-traumatic and effective procedure, leading to significant improvement of the left atrium morphometry and accompanied by low risk for postoperative lethality.

Author Biographies

V. V. Popov, Amosov National Institute of Cardiovascular Surgery, Kyiv

Popov Volodymyr V. - MD, DSci (Med), Professor
Head of Department of Surgical Treatment of Acquired Heart Diseases,
Amosov National Institute of Cardiovascular Surgery,
6, M. Amosova St., 03038, Kyiv, Ukraine
+38 067 402 24 39
vladpopov@ukr.net
https://orcid.org/0000-0002-2851-5589

A. A. Bolshak, Amosov National Institute of Cardiovascular Surgery, Kyiv

Bolshak Oleksandr O. - MD, PhD(Med),
Department of Surgical Treatment of Acquired Heart Diseases,
Amosov National Institute of cardiovascular surgery National,
6, M.Amosova Str., 03038, Kyiv, Ukraine
+38 097 194 79 98
bolshak2077@gmail.com
https://orcid.org/0000-0002-6089-9594

V. V. Lazoryshynets, Amosov National Institute of Cardiovascular Surgery, Kyiv

Lazoryshynets Vasyl V., MD, DSci(Med), Professor,
Director of the National Amosov Institute of Cardiovascular Surgery
6 N. Amosova str., Kyiv, 03680, Ukraine
https://orcid.org/0000-0002-1748-561X

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Published
2021-10-28
How to Cite
Popov, V. V., Bolshak, A. A., & Lazoryshynets, V. V. (2021). The arch-like plasty of the left atrium in correction of a mitral valve failure. Klinicheskaia Khirurgiia, 88(5-6), 18-22. https://doi.org/10.26779/2522-1396.2021.5-6.18
Section
General Problems of Surgery

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