[Experience of Treatment of Spontaneous Rupture of Left Ventricular Posterior Wall After Mitral Valve Replacement].

Spontaneous rupture of the left ventricular posterior wall after mitral valve replacement is a severe complication and is associated with high mortality rate. This complication was first described in 1967 by Roberts and Morrow, which describe the results of autopsy of two patients. In leading clinics around the world left ventricular wall ruptures after mitral valve replacement account for up to 20% of causes of hospital mortality. Currently there is no clear-cut strategy of treatment of this complication. In this article we present analysis of both traditional and non-traditional methods of treatment of this complication as well as own small positive and negative experience.

[Aortic valve replacement with stentless bioprosthesis: surgical technique and early outcomes].

AIM: To evaluate prospectively the hemodynamic performance of «BiolAB Mono¼ stentless bioprosthesis implanted into aortic position. MATERIAL AND METHODS: Twenty seven patients (mean age 71 (67; 73); 17 women) with severe aortic stenosis underwent, aortic valve replacement with «BioLAB Mono¼ stentless bioprosthesis from 2012 to 2014. The valves- were implanted into supraannular position using continuous polypropylene suture. RESULTS: In the early postoperative period 1 patient (3.7%) died for acute heart failure. The mean aortic cross-clamping time was 81 (75; 90) min. Echocardiographic peak pressure gradient were 18 (16;23) mmHg (postoperative). There were no cases of valve dysfunction In early 'postoperative period. Level of thrombocytes recovered after 1 O days postoperatively. CONCLUSION: «BioLAB Mono¼ aortic bioprosthesis implantation. is easy and reproducible. The valve has excellent hemodynamic performance ir;i early postoperative period.

[Aortic valve replacement with stentless bioprosthesis].

AIM: To evaluate prospectively the hemodynamic performance of «BioLAB Mono¼ stentless bioprosthesis implanted into aortic position. MATERIAL AND METHODS: Twenty seven patients (mean age 71 (67; 73); 17 women) with severe aortic stenosis underwent aortic valve replacement with «BioLAB Mono¼ stentless bioprosthesis from 2012 to 2014. The valves were implanted into supra-annular position using continuous polypropylene suture. RESULTS: In the early postoperative period 1 patient (3.7%) died for acute heart failure. The mean aortic cross-clamping time was 81 (75; 90) min. Echocardiographic peak pressure gradient were 18 (16; 23) mmHg (postoperative). There were no cases of valve dysfunction in early postoperative period. Level of thrombocytes recovered after 10 days postoperatively. CONCLUSION: «BioLAB Mono¼ aortic bioprosthesis implantation is easy and reproducible. The valve has excellent hemodynamic performance in early postoperative period.

[The mithral valve replacement with biological prostheses: early and long-term results].

442 patients underwent the mitral valve replacement (MVR) with KemCor and PeriCor stented bioprostheses. The study results justified the preference of the "totally biological" PeriCor valve in patients with active infectious endocarditis. The longest follow-up period was 11 years, the mean follow-up was 51±34 months. The risk of the structural valve disfunction was shown to be inversely proportional to the age (p=0.03). 38% of the operated women younger the 45, developed the structural valve disfunction in 79±27 months after surgery. Thus, MVR with stented bioprostheses proved to be clinically efficient early after the operation. Predictability of the results of KemCor and PeriCor valve implantation allows the theoretically substantiated approach to the rehabilitation, especially, considering the adverse event rate in different patient groups at certain follow-up periods.

[A case of severe intravascular hemolysis after double mechanical heart valve implantation].

A case report of a patient with a triple cardiac valve replacement complicated by severe postoperative intravascular hemolysis is presented. The patient had neither prosthetic valvular dysfunction nor paravalvular leak and had an excellent hemodynamic response to the operation. Replacement of the aortic and mitral prostheses with stented porcine prosthesis alleviated the problem.

[The study of microcirculation in walls of chambers of the heart in patients with aortic stenosis in dependence on heart failure stage].

We studied microcirculatory blood flow (MBF) by laser Doppler flowmetry (LDF) in 52 patients with stage III-IV aortic stenosis (AS) and class II-IV chronic heart failure (CHF). MBF was assessed in walls of right and left cardiac chambers before and after correction of the defect. Aim of this study was to assess functional state of MBF in walls of different chambers of the heart before and after defect correction in patients with AS at various stages of CHF. We distinguished 2 groups of patients: group 1 with class II CHF, group 2 with class III-IV CHF. In group 2 compared with group 1 before and after AS correction of AS we found the lowest level of MBF in walls of left cardiac chambers and right atrium and highest parameters of the left ventricular and atrial function according to echocardiography data. Progression of anatomic-functional changes of left ventricle at the background of AS and development of CHF is characterized by lowering of MBF volume velocity in walls of left cardiac chambers.

[Comparative characteristics of quality of life and physical status of patients with ischemic heart disease and aortic valve disease].

For comparison of physical status and quality of life of patients we analyzed 2 clinical groups: patients with ischemic heart disease (IHD) and aortic valve disease. Using original methodology of bringing results of questionnaire " Nottingham Health Profile " to functional classification we had a possibility to compare quality of life of patients with functional classes of physical working capacity and NYHA classification. Subjective component inserted into NYHA classification and quality of life questionnaire leads to substantial discrepancy with objective data on physical working capacity. In most cases patients of both clinical groups subjectively overestimate functional capacity of their organism. In patients with IHD most significant limitations manifest in psychic sphere of life, while in patients with aortic valve disease - in physical sphere of life, what demonstrates great effect of psychosomatic factor in development of IHD.