Comparative analysis of early postoperative results of transcatheter aortic valve implantation and surgical aortic valve replacement with a biological prosthesis.

OBJECTIVE: . Aim: The choice of aortic valve stenosis correction method is determined by a number of clinical and technical parameters. The task was to compare early postoperative outcomes in patients after correction of aortic valve stenosis using TAVI and surgical aortic valve replacement with a biological prosthesis. PATIENTS AND METHODS: Materials and Methods: This retrospective study analyzed the medical records of adult patients (18 years of age and older) who had transcatheter aortic valve implantation or surgical aortic valve replacement with a biological prosthesis at the State Institution "Heart Institute of the Ministry of Health" in the period from 2018 to 2022. RESULTS: Results: In 47 (47.5%) cases, TAVI was performed and in 52 (52.5%) cases, SAVR with a biological prosthesis was performed. Patients who underwent TAVI were significantly older (p=0.002) and had a higher EuroSCORE II operative risk score (p<0.001). In patients with TAVI, larger diameter aortic valve prostheses were significantly more often used compared with the SAVR group with biological prosthesis (27.5±2.74 vs. 22.5±1.84, p<0.001). The early postoperative period in patients with TAVI was characterized by an 11.4% (p=0.046) and 15.4% (p=0.006). The length of stay in the ICU (p=0.024), as well as the duration of hospitalization in general (p=0.005), was also significantly lower in patients with TAVI compared with patients with biological prosthesis SAVR. CONCLUSION: Conclusions: Despite the higher surgical risk of surgery according to EuroSCORE II, TAVI was characterized by a lower incidence of postoperative complications, with shorter duration of stay in ICU and hospitalization in general in comparison with patients undergoing SAVR with a biological prosthesis.

FIRST EXPERIENCE WITH OCCLUTECH PLD OCCLUDER TO CLOSE PARAVALVULAR LEAKS PROSTHETICS OF THE MITRAL VALVE. CASE REPORT.

This clinical case presents the results of using the Occlutech PLD occluder for transcatheter closure of a paravalvular leak (PVL) via a transapical approach in the remote period after mitral valve prosthetics. According to our results and to the literature, the procedure for closing the PVL of the mitral valve from a transapi¬cal approach using a special Occlutech PLD occluder is characterized by relative safety for patients, clinical effectiveness in terms of eliminating or reducing the degree of regurgitation and related symptoms.

Transcatheter aortic valve implantation in a patient with mitral valve replacement and tricuspid valve repair.

Aortic valve stenosis occurs in about 3% of people over 65. It is the most important heart valve disease in developed countries. Pathogenesis includes processes similar to those in atherosclerosis, including lipid accumulation, inflammation and calcification. A CASE REPORT: In this study, we describe the case transcatheter aortic valve implantation in a 73-year-old patient after mitral valve replacement and tricuspid valve repair 15 years ago. CONCLUSIONS: Transcatheter aortic valve implantation is an effective method of surgical treatment of elderly patients with aortic stenosis with a high risk of mortality in traditional surgical correction of defects. This type of treatment can be widely used in repeated interventions, where there is an adhesion process, technical complexity and a significant risk of complications. This method of treatment minimizes side effects and shortens the patient's rehabilitation period.

COMPLEX ORPHAN PATHOLOGY: COMORBIDITY OF MUCOVISCIDOSIS AND CONGENITAL DYSFUNCTION OF ADRENAL GLANDS CORTEX (REFERENCES REVIEW AND OWN RESEARCH).

OBJECTIVE: The aim: The clinical case was studied: comorbidity of mucoviscidosis and congenital dysfunction of adrenal glands cortex. PATIENTS AND METHODS: Materials and methods: The clinical case of combined orphan pathology - cystic fibrosis and congenital dysfunction of adrenal glands cortex (adrenogenital syndrome) has been described. RESULTS: Clinical case: A 2-month child has been diagnosed with mucoviscidosis, of a mixed form, which was genetically confirmed. The proband and the father were found to be heterozygotes for the F508del mutation of the CFTR gene (the father suffers from mucoviscidosis). Congenital dysfunction of the adrenal glands, a viral form, was diagnosed when he was three years old. The child is currently receiving: Creon 100 000 units per day with eating, Colomycin 1 vial per day, Pulmozyme 2.5 mg/2.5 ml daily in the morning for inhalations, Ursofalk 600 mg every day constantly, Hydrocortisone 50 mg/day. CONCLUSION: Conclusions: This clinical case can be attributed to rare, as most such pathological conditions are usually diagnosed in maternity homes along with the prescription of appropriate therapy. This is an example of late diagnosis of the viral form of congenital adrenal dysfunction against the background of cystic fibrosis, indicating the need for earlier detection and timely introduction of substitution therapy to improve favourable prognosis for a disease.