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.

ECHOCARDIOGRAPHIC ASPECTS OF ASSESSMENT OF MITRAL INSUFFICIENCY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION.

OBJECTIVE: The aim is to analyze patients with acute myocardial infarction with reduced ejection fraction in order to determine risk factors for mitral insufficiency. PATIENTS AND METHODS: Materials and methods: The study included 149 patients with acute myocardial infarction. Among the patients, there were 113 males (75.8%) and 36 females (24.2%). The age of the patients ranged from 43 to 86 years. Echocardiography was performed using a Phillips Epiq 7 machine. Patients were examined three times: upon admission to the hospital, after revascularization, and six months after discharge. Patients received transthoracic echocardiography, which was used to determine the presence and degree of mitral regurgitation. RESULTS: Results: According to the results of the study, it was found that the presence of concomitant somatic pathology worsens the course of an acute myocardial infarction, in turn increasing the likelihood of valvular pathology. An increase in left ventricular volume indicators, such as end-diastolic volume, end-systolic volume, end-diastolic index, and the index of contractile function (ejection fraction) contributes to the development of mitral valve insufficiency. CONCLUSION: Conclusions: The presence of mitral regurgitation in patients with acute myocardial infarction and reduced left ventricular ejection fraction worsens the course of the disease and negatively affects the prognosis.

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.