[Comparative evaluation of Soviet-made mechanical prostheses in the mitral position]. / Sravnitel'naia otsenka otechestvennykh mekhanicheskikh protezov v mitral'noi pozitsii.

The authors appraised comparatively the 25 ball prosthesis (group 1), the rotational-disk prosthesis (group 2) and the prostheses (group 3) in 180 patients who underwent operation in the period between 1983 and 1988. The hospital lethality was 7.5% in group 1, 2.7% in group 2, and 4.8% in group 3. After dismissal from the clinic 98.2% of patients were studied in postoperative periods of 6 months to 5 years. Five-year survival after operation was 76.6 +/- 3.6%, 97.3 +/- 0.8%, and 87.7 +/- 1.2%, respectively. By the 5th postoperative year, no thromboembolic complications were encountered in 88.3 +/- 3.6% of patients in group 1, 97.3 +/- 0.8% of patients in group 2, and 91.5 +/- 2.4% of patients in group 3. The mean diastolic gradient was 7.05 +/- 0.75 mm Hg on the prosthesis, 3.98 +/- 0.44 mm Hg on the prosthesis, and 4.27 +/- 0.47 mm Hg on the prosthesis. At the time of the examination, 87.5% of group 1 patients, 88.2% of group 2 patients, and 87.1% of group 3 patients were related to I and II functional classes.

[Comparative hemodynamic characteristics of Soviet-made mechanical heart valve prostheses in the mitral position]. / Sravnitel'naia gemodinamicheskaia kharakteristika otechestvennykh mekahnicheskikh protezov klapanov serdtsa v mitral'noi pozitsii.

The article deals with hemodynamic evaluation of Soviet-made, and heart valve prostheses in late-term periods after operation for mitral valve replacement. Fourty-six patients were examined: a ball prosthesis was implanted in 21 patients (1st group), as disk prosthesis--in 15 patients (2nd group) and a prosthesis--in 10 patients (3rd group). A good clinical result of the operation was achieved in all patients, they were referred to functional class I and II. Catheterization of the left and right parts of the heart, left ventriculography, and test with dosed physical exertion were carried out. Loading was continued till cardiac output increased approximately by 60 per cent in 6 patients of the 1st group, 12 patients of the second group, and in all 10 patients of the 3rd group. The study showed that the prostheses do not yield to foreign models of heart valves in hemodynamic characteristics and cause a lower stenosing effect than the prostheses do. No essential differences were detected between the prostheses.

[Clinical characteristics of the Soviet low-profile heart valve prostheses EMIKS and LIKS]. / Klinicheskaia kharakteristika otechestvennykh nizkoprofil'nykh protezov klapanov serdtsa EMIKSA i LIKS.

The present work is devoted to the clinical assessment of the Soviet-made cardiac valve prostheses 'EMIKS' and 'LIKS'. From 1983 to May 1, 1988, 632 prostheses were implanted to 508 patients. A group of 348 patients were assessed: 139 after mitral (M) replacement, 130 after aortal (A) replacement, and 79 after mitral-aortal (M+A) replacement. Hospital mortality rate was: in M group--4.3 per cent, in A group--5.3 per cent, in M+A group--8.8 per cent. Survival rate on the fifth postoperative year was: in M group--89.5 +/- 9.2 per cent, in a group--90.0 +/- 4.2 per cent, in M+A group--91.0 +/- 6.2 per cent, the stability of the good results being 85.5 +/- 7.2, 79.5 +/- 6.2, and 75.0 +/- 9.1 per cent, respectively. At year 5 of the follow-up, patient numbers without thromboembolic complications amounted to 95.0 +/- 4.7 per cent in M group, 95.5 +/- 4.2 per cent in A group, and 85.0 +/- 9.1 in M+A group. 95.1 per cent patients belong to functional classes I and II. In mitral replacement, the mean 'EMIKS' gradient was 4.2 +/- 0.58 mm Hg, the 'LIKS' one--4.58 +/- 0.62 mm Hg. Intravascular hemolysis was not observed. The 'EMIKS' and 'LIKS' prostheses match the models produced in other countries. No significant differences between the two models were found.