Pukas K. Remote results after mitral valve replacement

Clinical material is based on research 634 adult patients with the aquired mitral valve disease of heart, that in a period from 2005- 2006 years the mitral valve replacement was executed. On the basis of the conducted analysis there were clarified the specified indications to the operation, were determined the optimal variants of correction, that lead to the best remote results. The main risk factors were determined, which influence on the remote period after mitral valve replacement, based on which the clinical examination for this category of patients was improved. It is well-proven that in a remote period after mitral valve replacement 67,0 % cases had a good and satisfactory result of operation. At that on the stage of 10 years: survivability presented 69,4%, stability of good and satisfactory results - 57,3%, absence of thromboembolic complications - 79,7%, absence of the repeated operations - 95,4%. Well-proven necessity of complex radical reconstruction of mitral valve : а) mitral valve replacement with maintenance of chordo-papillar continium for maximal maintenance of retractiveness of left ventricle; b) removal of apendage of left atrium; c) plastic of left atrium; d) operation Maze. Patients of the complicated group (concomitant coronary artery bypass grafting and ischemic heart disease, reduced retractiveness of left ventricle, left atriomegaly, thrombosis of left atrium) must be under a thorough clinical supervision, severely follow to anticoagulating therapy in combination with antiagregant component, pass the annual transesophagal inspection of prosthesis function and coronarography.It is well-proven that mitral valve replacement is better to execute for patients in II - III functional class with the stored sinus rhythm than in IV functional class after New York classification (NYHA) (р <0,05).