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Prosthetic heart valves are widely used biomedical devices. The need for these prostheses is increasing due to the increasing life expectancy of the general population and the consequent incidence of age-related degenerative valvular defects. However, even though mechanical prosthetic valves have been significantly modernized over the last decades, they are still associated with several life-threatening complications, the main one being thrombosis. Addressing this problem is challenging and requires collaboration between bioengineering and cardiothoracic surgery. Thus, the problem of creating the most adapted model of prosthetic heart valve (PHV) turns out to be at the confluence of sciences – medicine, biology, applied mechanics, mathematical modeling, etc. Today, it seems clear that the engineering ideas for hemodynamic adaptation of PHV models have been fully developed. However, research in the field of materials science, as well as a search for surface modification methods, remain a pressing bioengineering challenge.
Prosthetic heart valves are widely used biomedical devices. The need for these prostheses is increasing due to the increasing life expectancy of the general population and the consequent incidence of age-related degenerative valvular defects. However, even though mechanical prosthetic valves have been significantly modernized over the last decades, they are still associated with several life-threatening complications, the main one being thrombosis. Addressing this problem is challenging and requires collaboration between bioengineering and cardiothoracic surgery. Thus, the problem of creating the most adapted model of prosthetic heart valve (PHV) turns out to be at the confluence of sciences – medicine, biology, applied mechanics, mathematical modeling, etc. Today, it seems clear that the engineering ideas for hemodynamic adaptation of PHV models have been fully developed. However, research in the field of materials science, as well as a search for surface modification methods, remain a pressing bioengineering challenge.
Aim. To compare the results of mitral valve replacement with the full-flow mechanical valve MedInzh-ST and the classical prosthesis MedInzh-2, to learn the structural and functional parameters of the heart depending from the prosthesis in the long-tern period. Material and methods. From 2015 to February 2020 years an the basis of the cardio-surgical department of the Regional clinical Hospital 116 patients, in order to correct defects, were underwent mitral prosthetics with MedInzh valves. Of these 55 patients received a new full-flow valve MedInzh-ST. 61 patients a classical MedInzh-2. Before surgery and in the long-term period all patients were underwent transthoracic echocardiography with using expert-class devices. In the long-tern postoperative period 34 patients were underwent echocardiographic research after implantation full-flow valves and 40 patients after prosthetics of classical prosthesis. Results. The choice of the prosthesis model did not affect the incidence of postoperative complications and the rate of hospital mortality. In all cause of death is not associated with impaired function of the prosthesis. All patients before the discharge from hospital were fixed the positive effect from surgical treatment. In the long-term postoperative period between patients after implantation of full-flow valves, the cases of prosthetic platelets were not registered. One patient was diagnosed with prosthetic thrombosis after implantation of a classical prosthesis, which required further reprosthetics. There were no signs of prosthetic endocarditis and paraprosthetic fistula in both groups. There were no significant differences in the structural and geometric parameters of the heart in all patients. Conclusion. Analysis of the functional characteristics of the new full-flow valve MedInzh-ST in the long-term period allows us to conclude that the new valve model meets modern requirements for efficiency and safety.
Objective. To analyze the immediate and medium-term results of prosthetics of the aortic valve (AV) using biological prosthesis in elderly patients. Material and methods. The study included 198 patients with AV pathology [85 men (42.9 %)/113 women (57.1 %)]. The median age was 70 [66–73] years. There were 175 (88.4 %) patients with sclerodegenerative AV, 5 (2.5 %) – with infectious endocarditis and 30 patients (15.2 %) had bicuspid AV. Results. The hospital mortality was 4.5 %. The causes of mortality were multiple organ failure syndrome, in 1 case – developed peritonitis. In 14 patients (7.1 %) there was a rhythm disturbance in the form of AF, in 9 (4.5 %) – a complete AV block, in connection with which a permanent pacemaker was implanted. Four patients (2 %) underwent resternotomy for bleeding. Two patients (1 %) underwent pericardiocentesis. 8 (4 %) patients developed a stroke. No wound complications were detected. In the long-term period, 31 patients died. The causes of mortality were the following: cardiovascular diseases – 13 patients, malignant neoplasms – 5 patients, gastrointestinal diseases – 2, urinary system disease – 1 patient, COVID-19 – 1 patient, unknown cause – 9 patients. Thus, the five-year survival rate after the surgery was 63 %, respectively. During the follow-up period, 2 patients (2.9 %) underwent repeated intervention on AV. Conclusions. The five-year freedom from re-operation was 97.1 %. The five-year survival rate was 63 % due to the presence of a history of severe concomitant pathology as well as the middle age of patients 70 years.
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