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XXVIII Пленум Правления Белорусской ассоциации хирургов
«Актуальные вопросы и современные подходы в оказании
хирургической помощи в Республике Беларусь»
18-19 ноября 2021 года в г. Минск.
Year 2020 Vol. 28 No 4
GENARAL & SPECIAL SURGERY
YU.V. BELOV 1, K.N. RYBAKOV 2, 3, I.A. GUBAREV 2, A.Z. SALEKH 2, I.A. VINOKUROV 3
IMMEDIATE TREATMENT RESULTS OF PATIENTS WITH AORTIC VALVE DISEASE IN COMBINATION WITH POSTSTENOTIC DILATION OF THE ASCENDING AORTA LESS THAN 5 CM
Russian Research Surgery Center named after Academician B.V.Petrovsky 1,
N.I. Pirogov Municipal Clinical Hospital No1 2,
I.M. Sechenov First Moscow State Medical University
(Sechenov University) of the Ministry of Health of Russia 3, Moscow,
The Russian Federation
Objective. To carry out a comparative evaluation of immediate results of isolated operations on the aortic valve and combined surgical intervention on the aortic valve and ascending aorta in patients with aortic valve defects in combination with poststenotic dilation of the ascending aorta less than 5 cm.
Methods. The article analyzes the results of surgical treatment of patients (n=39) with the aortic valve defects in combination with ascending aortic aneurysms. The differences were in the tactics of surgical treatment: 22 patients underwent combined surgery on the aortic valve and ascending aorta, 17 patients underwent isolated operations on the aortic valve. In each of the study groups, intraoperative data, rehabilitation period, and complications in the early postlesional period were evaluated.
Results. Statistical analysis revealed no significant difference in the rehabilitation period and complications in the early postlesional period between the main group and the comparison group except of the index of postoperative bleeding, which was significantly higher in patients who underwent combined surgery on the aortic valve and ascending aorta and recorded in 18.2% of cases (p=0.03).
Conclusion. A moderate increase in the duration of the operation and artificial blood circulation, as well as intraoperative blood loss due to the formation of an additional anastomosis in the ascending aorta in patients undergoing combined replacement of the aortic valve and ascending aorta in comparison with isolated aortic valve replacement does not significantly affect the postoperative rehabilitation period and the incidence of complications in the early postlesional period. The final decision on the feasibility of performing combined prosthetics of the aortic valve and ascending aorta in patients with aortic valve defect in combination with poststenotic dilation of the ascending aorta less than 5 cm requires additional comparative analysis of long-term results of surgical treatment of the studied groups of patients.
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119049, Russian Federation,
Moscow, Leninsky pr., 8,
N.I. Pirogov Municipal Clinical Hospital No1,
Center for Vascular, X-ray Endovascular Surgery
and Minimally Invasive Phlebology Unit,
tel. mobile:+7 985 353 51 90,
Gubarev Igor’ Aleksandrovich
Belov Yurii V., MD, Professor, Academician of RAS, Head of the Cardio-aortic Surgery, Russian Research Surgery Center named after Academician B.V.Petrovsky, Moscow, Russian Federation.
Rybakov Kirill N., Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
Gubarev Igor’ A., Aspirant, Russian Research Surgery Center named after Academician B.V.Petrovsky, Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
Salekh Amro Z., PhD, Cardiovascular Surgeon, N.I. Pirogov Municipal Clinical Hospital No1, Moscow, Russian Federation.
Vinokurov Ivan A., PhD, Associate Professor of the Hospital Surgery Department, I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of Russia, Moscow, Russian Federation