SUMMARY OF LONG TERM EXPERIENCE IN ACQUIRED HEART DISEASES SURGERY
https://doi.org/10.15825/1995-1191-2014-3-39-44
Abstract
In this article we discuss the results of surgical treatment in patients with different acquired heart diseases. Procedures ranged from valve reconstruction, coronary artery revascularization, surgical repair or graft repair of the thoracic aorta to hybrid surgery in patients with combined acquired heart valve diseases and coronary artery diseases. The implementation of biological grafts for aortic repair in 147 cases was successfully performed with low in-hospital mortality (9.8%). Hybrid procedures in patients older than 70 years allowed reducing hospital mortality rate in 3 times in comparison with the standard surgery: 4% vs. 12%, respectively. We developed and introduced into clinical practice the original protocol for patients with aortal valve disease and low left ventricular
ejection fraction (mean – 24.3%). Due to this protocol 46 procedures were performed, in-hospital mortality was 4.4%. Cardiac surgery in patients on dialysis is one of the priorities in our practice. Our experience demonstrates that short waiting time of kidney transplantation after heart valve replacement improves long-term outcomes.
About the Authors
M. L. Semenovsky
V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
Russian Federation
Russian Federation
Professor, Head of Division cardiovascular surgery № 1 V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs, Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
G. A. Akopov
V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
Russian Federation
Leading Research Fellow at the same division
Russian Federation
Leading Research Fellow at the same division
G. V. Aniskevich
V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
Russian Federation
cardiovascular surgeon at the same division
Russian Federation
cardiovascular surgeon at the same division
E. K. Mekhtiev
V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
Russian Federation
cardiovascular surgeon at the same division
Russian Federation
cardiovascular surgeon at the same division
N. N. Tarabarko
V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
Russian Federation
surgeon at the same division
Russian Federation
surgeon at the same division
D. A. Belokurov
V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
Russian Federation
surgeon at the same division
Russian Federation
surgeon at the same division
References
1. Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA. 2000; 283: 897.
2. Семеновский МЛ, Акопов ГА. Альтернативный метод хирургической коррекции расслаивающих аневризм аорты в сочетании с аортальной недостаточностью. Вестник трансплантологии и искусственных органов. 2009; XI (4): 30–39. Semenovskiĭ ML, Akopov GA. Al'ternativnyĭ metod khirurgicheskoĭ korrektsii rasslaivayushchikh anevrizm aorty v sochetanii s aortal'noĭ nedostatochnost'yu. Vestnik transplantologii i iskusstvennykh organov = Russian Journal of Transplantology and Artifi cial Organs. 2009; XI (4): 30–39.
3. Муслимов РШ. Биокондуиты в хирургии аневризм восходящего отдела аорты. Дис. … канд. мед. наук. М., 2004. Muslimov RSh. Biokonduity v khirurgii anevrizm voskhodyashchego otdela aorty. Dis. ... kand. med. nauk. M., 2004.
4. Тарабарко НН, Семеновский МЛ, Акопов ГА, Попцов ВН. Ретроградная перфузия головного мозга как метод его защиты во время гипотермической остановки кровообращения при операциях на восходящем отделе и дуге аорты. Вестник трансплантологии и искусственных органов. 2011; XIII (3): 41–45. Tarabarko NN, Semenovskiĭ ML, Akopov GA, Poptsov VN. Retrogradnaya perfuziya golovnogo mozga kak metod ego zashchity vo vremya gipotermicheskoĭ ostanovki krovoobrashcheniya pri operatsiyakh na voskhodyashchem otdele i duge aorty. Vestnik transplantologii i iskusstvennykh organov = Russian Journal of Transplantology and Artifi cial Organs. 2011; XIII (3): 41–45.
5. Craver JM, Puskas JD, Weintraub WW, Shen Y, Guyton RA, Gott JP. 601 octogenarians undergoing cardiac surgery: outcome and comparison with younger age groups. Ann. Thorac. Surg. 1999; 67: 1104–1110.
6. Langanay T, De Latour B, Ligier K, Derieux T., Agnino A., Verhoye JP. Surgery for aortic stenosis in octogenarians: infl uence of coronary disease and other comorbidities on hospital mortality. J Heart Valve Dis. 2004; 13: 545–552.
7. Nagendran Jayan, Colleen Norris, Andrew Maitland, Arvind Koshal, Ross DB. Is mitral valve surgery safe in octogenarians? Eur J Cardiothorac Surg. 2005; 28: 83–87.
8. Valle Felipe H, Altamiro R Costa, Edemar MC Pereira, Eduardo Z Santos. Morbidity and Mortality in Patients Aged over 75 Years Undergoing Surgery for Aortic Valve Replacement. Arq Bras Cardiol. 2010 Jun; 94 (6): 720–725.
9. Олофинская ИЕ. Результаты хирургического лечения приобретенных пороков сердца у больных пожилого возраста; факторы риска, прогноз. Дис. … докт. мед. наук. М., 2010. Olofi nskaya IE. Rezul'taty khirurgicheskogo lecheniya priobretennykh porokov serdtsa u bol'nykh pozhilogo vozrasta; faktory riska, prognoz. Dis. ... dokt. med. nauk. M., 2010.
10. David M Shahian, Sean M. O'Brien, Giovanni Filardo, Rachel S Dokholyan, Victor A Ferraris. The Society of Thoracic Surgeons 2008 Cardiac Surgery Risk Models: Part 3–Valve Plus Coronary Artery Bypass Grafting Surgery. Ann Thorac Surg. 2009; 88: 43–62.
11. Byrne JG, Leacche M, Unic D, Rawn JD, Simon DI, Rogers CD, Cohn LH. Staged initial percutaneous coronary intervention followed by valve surgery («hybrid approach ») for patients with complex coronary and valve disease. J Am Coll Cardiol. 2005; 45: 14–18.
12. Brinster DR, Byrne M, Rogers CD, Baim DS, Simon DI, Couper GS, Cohn LH. Effectiveness of same day percutaneous coronary intervention followed by minimally invasive aortic valve replacement for aortic stenosis and moderate coronary disease («hybrid approach»). Am J Cardiol. 2006; 98: 1501–1503.
13. Ramanan Umakanthan, Marzia Leacche. Combined PCI and Minimally Invasive Heart Valve Surgery for High-Risk Patients. Current Treatment Options in Cardiovascular Medicine. 2009; 11: 492–498.
14. Connolly HM, Jay K, Hartzell V et al. Severe aortic stenosis with low transvalvular gradient and severe left ventricular dysfunction. Circulation. 2000; 101: 1940– 1946.
15. Powell DE, Paul A Tunick, Barry P Rosenzweig et al. Aortic Valve Replacement in Patients With Aortic Stenosis and Severe Left Ventricular Dysfunction. Arch Intern Med. 2000; 160: 1337–1341.
16. Chaliki HP, Mohty D, Avierinos J-F et al. Outcomes after aortic valve replacement in patient with severe aortic regurgitation and markedly reduced left ventricular function. Circulation. 2002; 106: 2687–2696.
17. Rothenburger M, Drebber K, Tjan TD et al. Aortic valve replacement for aortic regurgitation and stenosis, in patients with severe left ventricular dysfunction / M. Rothenburgera. Eur. J. Cardiothorac. Surg. 2003; 23: 703–709.
18. Sharony R, Eugene A. Grossi, Paul C. Saunders et al. Aortic valve replacement in patients with impaired ventricular function. Ann. Thorac. Surg. 2003; 75: 1808– 1814.
19. Tarantini G, Buja P, Scognamiglio R et al. Aortic valve replacement in severe aortic stenosis with left ventricular dysfunction: determinants of cardiac mortality and ventricular function recovery. Eur J Cardiothorac Surg. 2003; 24: 879–885.
20. Vaquette B, Corbineau H, Laurent M et al. Valve replacement in patients with critical aortic stenosis and depressed left ventricular function: predictors of operative risk, left ventricular function recovery, and long term outcome. Heart. 2005; 91 (10): 1324–1329.
21. Джангулян НГ. Эффективность хирургической коррекции аортального стеноза в группе пациентов с низкой сократительной способностью миокарда. Врач-аспирант. 2005; 24: 12. Dzhangulyan NG. Effektivnost' khirurgicheskoĭ korrektsii aortal'nogo stenoza v gruppe patsientov s nizkoĭ sokratitel'noĭ sposobnost'yu miokarda. Vrach-aspirant. 2005; 24: 12.
22. Levy F, Laurent M, Monin JL et al. Aortic valve replacement for low-fl ow/low-gradient aortic stenosis. J Am Coll Cardiol. 2008; 51: 1466–1472.
23. Halkos ME, Edward P. Chen, Eric L. Sarin et al. Aortic valve replacement for aortic stenosis in patients with left ventricular dysfunction. Ann Thorac Surg. 2009; 88: 746–751.
24. Wen-Hong Ding, Yat-Yin Lam, Alison Duncan et al. Predictors of survival after aortic valve replacement in patients with low-fl ow and high gradient aortic stenosis. Eur J Heart Failure. 2009; 11 (9): 897–902.
25. Шматов ДВ, Железнев СИ, Астапов ДА, Караськов АМ и др. Непосредственные результаты протезирования аортального клапана у пациентов с аортальным стенозом и систолической дисфункцией левого желудочка. Патология кровообращения и кардиохирургия. 2010; 4: 24–28. Shmatov DV, Zheleznev SI, Astapov DA, Karas'kov AM et al. Neposredstvennye rezul'taty protezirovaniya aortal'nogo klapana u patsientov s aortal'nym stenozom i sistolicheskoĭ isfunktsieĭ levogo zheludochka. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2010; 4: 24–28.
Review
For citations:
Semenovsky M.L., Akopov G.A., Aniskevich G.V., Mekhtiev E.K., Tarabarko N.N., Belokurov D.A. SUMMARY OF LONG TERM EXPERIENCE IN ACQUIRED HEART DISEASES SURGERY. Russian Journal of Transplantology and Artificial Organs. 2014;16(3):39-44. (In Russ.) https://doi.org/10.15825/1995-1191-2014-3-39-44
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