The left atrium plasty in surgical correction of combined mitral-aortal failure, complicated by the left-sided atriomegaly

Keywords: left atriomegaly, triangular plasty of the left atrium, prosthesis of mitral and aortal valves, plasty of a mitral valve, artificial blood circulation

Abstract

Objective. Studying of possibilities of the left atrium triangular plasty procedure in correction of combined mitral-aortal failure, complicated by the left-sided atriomegaly.

Materials and methods. Into the analysis the results of surgical treatment in 360 patients, suffering combined mitral-aortal failure, combined with left-sided atriomegaly, who were operated in Amosov National Institute of Cardiovascular Surgery through period from 01.01.2006 to 01.01.2021 yr, were included. In the main group, consisting of 73 patients, original procedure of the left atrium triangular plasty was performed while correcting a combined mitral-aortal failure. In the control group, consisting of 287 patients, correction of combined mitral-aortal failure in presence of concomitant left-sided atriomegaly was performed only.

Results. Of 73 operated patients of the main group 3 died (lethality have constituted 4.1%). Dynamics of echocardiographic indices in the main group of patients in accordance to stagesof treatment was following: definitely-systolic index of the left ventricle – (69.1 ± 12.1) ml/m2 preoperatively, (59.3 ± 8.5) ml/m2 postoperatively, (48.4 ± 9.5) ml/m2 in late period; the ejection fraction of the left ventricle – 0.51 ± 0.05 preoperatively, 0.54 ± 0.05 postoperatively, 0.56 ± 0.04 in late period. Diameter of the left atrium – (65.8 ± 4.1) mm preoperatively, (52.3 ± 2.1) mm postoperatively, (53.5 ± 2.2) mm in late period. Of 287 operated patients of control group 9 died (lethality have constituted 3.1%). Dynamics of echocardiographic indices in the main group patients on the treatment stages was following: definitely-systolic index of the left ventricle – (68.3 ± 11.3) ml/m2 preoperatively, (60.4 ± 9.3) ml/m2 postoperatively, (52.7 ± 7.2) ml/m2 in late period; the ejection fraction of the left ventricle – 0.52 ± 0.05 preoperatively, 0.53 ± 0.05 postoperatively, 0.5 ± 0.04 in late period. Diameter of the left atrium – (66.5 ± 3.7) mm preoperatively, (64.5 ±3.3) mm postoperatively, (73.5 ± 2.8) in late follow-up period.

Conclusion. While performing operation for the left-sided atriomegaly the correction of triangular plasty of the left atrium constitutes a mini-invasive and effective procedure, leading to significant improvement in the left atrium morphometry and accompanied by low risk of lethality as well as thromboembolic complications.

Author Biographies

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

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, Kiev

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

Yu. V. Bakhovskya, Amosov National Institute of Cardiovascular Surgery, Kiev

Bakhovska Yulia, MD, Cardiologist,
Department of the Consultative Polyclinic
Amosov National Institute of cardiovascular surgery
6 N. Amosova str., Kyiv, 03680, Ukraine
+380969561183
Dyakyuliya439@gmail.com
https://orcid.org/0000-0003-0338-4479

N. V. Povoroznyk, Amosov National Institute of Cardiovascular Surgery, Kiev

Povoroznyk N. V., MD, cardiologist,
Department of the Consultative
Amosov National Institute of cardiovascular surgery
6 Amosova str., 03680 Kyiv. Ukraine
+380662981403
nataliapovoroznik184@gmail.com

https://orcid.org/0000-0002-0224-184X

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

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
2021-11-28
How to Cite
Popov, V. V., Bolshak, A. A., Bakhovskya, Y. V., Povoroznyk, N. V., & Lazoryshynets, V. V. (2021). The left atrium plasty in surgical correction of combined mitral-aortal failure, complicated by the left-sided atriomegaly. Klinicheskaia Khirurgiia, 88(7-8), 26-31. https://doi.org/10.26779/2522-1396.2021.7-8.26
Section
General Problems of Surgery