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Year 2014 Vol. 22 No 4
GENERAL AND SPECIAL SURGERY
S.V. SPIRYDONAU1, A.P. SHKET1, Y.M. CHESNOV1, N.N. SHCHATSINKA1, V.A. ADZINTSOU1, V.V. SCUMAVETZ1, V.V. ANDRUSCHUK1, A.A. KOAROVSKY1, Y.P. OSTROVSKY1,2
THE IMMEDIATE RESULTS OF AORTIC VALVE REPLACEMENT WITH ALLOGRAFTS
SE “Republican Scientific Practical Center “Cardiology”1,
SEE “Belarusian Medical Academy of Post-Graduate Education” 2, Minsk,
The Republic of Belarus
Objectives. To evaluate the immediate clinical results of aortic valve replacement with allografts.
Methods. Aortic valve replacement with allografts has been performed in 40 patients. Cryopreserved allografts were used in 33 cases (82,5%); fresh sterilized allografts – in 5 (12,5%); homovital allografts – in 2 (5%).
Indications for allograft use were: infective endocarditis of aortic valve (11 patients, 27,5%), prosthetic valve endocarditis (15 patients, 37,5%), prosthetic dysfunction (3 patients, 7,5%), aortic valve defects of different etiology (11 patients, 27,5%). Dimensions of allografts varied from 21 mm to 27 mm. The prosthetics has been performed as full root replacement in 35 cases (87,5%), the technique of subcoronary allograft implantation – in 5 cases (12,5%).
Results. The 30-day postoperative mortality rate was 15,0% (6 patients). At discharge the peak gradient was 17,9±12,4 mm Hg for the 21-mm prosthesis, 16,0±8,3 mm Hg for 23-mm prosthesis, 10,8±3,1 mm Hg for 25-mm prosthesis, 8,7±3,8 mm Hg for 27-mm prosthesis.
Conclusions. Early postoperatively the allografts in aortic position show low transprosthetic gradient. regardless of the valve size implanted. Allograft implantation is considered to be an alternative to mechanical and biological prostheses in patients with infective and prosthetic endocarditis, as well as in elderly patients with a narrow aortic annulus diameter.
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220036, Respublika Belarus, g. Minsk, ul. R. Lyuksemburg, d. 110, GU RNPTs «Kardiologiya», 2-e kardiokhirurgicheskoe otdelenie,
Spiridonau Sergey Viktorovich
Spirydonau S.V. PhD, a cardiac surgeon of SE RSPC “Cardiology”.
Shket A.P. PhD, a cardiac surgeon, a head of the 2nd cardiac surgery unit of SE RSPC “Cardiology”.
Chesnov Y.M. MD, a cardiac surgeon of SE RSPC “Cardiology”.
Shchatsinka N.N. A cardiac surgeon of SE RSPC “Cardiology”.
Adzintsou V.O. A cardiac surgeon of SE RSPC “Cardiology”.
Shumavetz V.V. PhD, a cardiac surgeon of SE RSPC “Cardiology”.
Andruschuk V.V. PhD, a cardiac surgeon of SE RSPC “Cardiology”.
Komarovsky V.V. A cardiac surgeon of SE RSPC “Cardiology”.
Ostrovsky Y.P. MD, professor, a corresponding member oà NAS RB, a head of the laboratory of the heart surgery of SE RSPC “Cardiology”, a head of the cardiac surgery chair of SEE “Belarusian Medical Academy of Post-graduate Education”.