Novosti
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This journal is indexed in Scopus |
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Year 2015 Vol. 23 No 1
GENERAL AND SPECIAL SURGERY
V.V. PODPALOV
THE LONG-TERM RESULTS OF SURGICAL REPAIR OF AORTIC STENOSIS
SE "Republican Scientific and Practical Centre "Cardiology", Minsk
The Republic of Belarus
Objectives. To analyze the survival rate after surgery in patients with severe aortic stenosis (AS) complicated by atrioventricular valves insufficiency and to evaluate importance of echocardiographic parameters for estimating the prognosis of 5-year mortality in the ginen patient’s category.
Methods. A prospective study has been conducted. Out of all patients treated at the Center in 2005-2007 yrs., 198 patients with severe stenosis of the aortic valve and relative insufficiency of the mitral and tricuspid valves have been included in the study. The patients were divided into 2 groups: the 1st group – 46 patients not operated for different reasons; the 2nd group – 152 patients who had undergone aortic valve replacement (AVR) combined with the atrioventricular valves plasty. Follow-up period made up 5 years.
Results. The average age of 198 patients was 59,16 years, proportion of men – 67%. Hospital mortality of operated patients was 0,7%. Within 5 years 35 patients (76,1%) died in the 1st group and 28 persons (18.4%) – in the 2nd group, that was significantly lower after adjusting for age and sex (p=0,0001). Considering age, sex and effect of surgery the statistically significant correlation was detected between the increasing of 5-year mortality and the following echocardiographic parameters changes by: the increasing of maximal (p=0,0008) and average (p=0,0011) gradients; left atrium diameter (p=0,0023); end-diastolic (p=0,0355), end-systolic (p=0,0021) of left ventricular (LV) diameters; end-diastolic (p=0,0001), end-systolic (p=0,0001) LV volumes; LV myocardial mass (p=0,0001); pulmonary artery systolic pressure (p=0,0001); right ventricle diameter (p=0,0001); reduction of LV ejection fraction (p=0,0076).
Conclusion. Aortic valve replacement (AVR) in combination with the atrioventricular valves plasty reliably improves the survival rate in the late postoperative period in patients with severe AS complicated by atrioventricular valves insufficiency. Presented echocardiographic parameters statistically significantly affect the risk of 5-year mortality in these patients.
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220036, Respublika Belarus, g. Minsk,
ul. R. Lyuksemburg, d. 110,
GU "Respublikanskiy nauchno-prakticheskiy
tsentr "Kardiologiya",
3-e kardiohirurgicheskoe otdelenie,
tel. office: +375 17 208-67-35,
e-mail: v.podpalov@gmail.com,
Podpalov Vladislav Vladislavovich
Podpalov V.V. An junior researcher of SE "Republican Scientific and Practical Centre "Cardiology", Minsk.
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