[Late results of mitral valve prosthesis]. / Otdalennye rezul'taty protezirovaniia mitral'nogo klapana.

The late results of mitral valve prosthetics were studied in 100 patients one to six years after surgery. Survival which was estimated by the actuarial method was 79.4% (15 patients died 2 to 34 months after the operation). The data obtained confirm the effectiveness of mitral valve prosthetics by means of the Soviet made MKch--25 and MKch--27 protheses. The operation ensures normalization of hemodynamics. Thromboembolic complications and bacterial endocarditis still present a serious problem. Patients with an implanted mitral valve prosthesis should be kept under dispensary surveillance.

[Rhythm disorders and their correction in connection with mitral valve prosthesis]. / Narusheniia ritma i ikh korrektsiia v sviazi s protezirovaniem mitral'nogo klapana.

The course of the operative procedure of mitral valve prosthetic replacement was analyzed in 180 cases. All patients during perfusion developed certain disorders in the processes of excitation and myocardium conductivity that manifested themselves in different kinds of arrhythmias. In 23 cases ventricular fibrillation was recorded during the intervention, in 4 cases--a full atrioventricular block. The main causes of the severe arrhythmias consisted in coronary circulation disorders caused by temporary cross-damping of the aorta, air embolism, inadequacy of the perfusion, compression of the circumflex branch of the left coronary artery by a ligature or haematoma. Severe rhythm disorders usually occurred in patients with cardiomegaly and distinct dystrophic changes in the myocardium. Electric defibrillation was conducted after mitral valve prosthetic replacement in 57 patients for the management of chronic cardiac fibrillation, a positive effect being achieved in 47 of them. The most reasonable period for electroimpulse therapy in patients with IIA stage of circulation disorders is 3-4 weeks after surgery, while in those with IIB stage--5-6 months therafter.

[Heart valve prosthesis in mitral valve defects of patients with chronic circulatory insufficiency]. / Protezirovanie klapana pri mitral'nykh porokakh serdtsa u bol'nykh s khronicheskoi nedostatochnost'iu krovoobrashcheniia

The data of long-term follow-up of 67 patients subjected to mitral valve replacement for severe heart diseases support the rationale of surgical management of chronic circulatory insufficiency in mitral disease. A prosthetic replacement of the mitral valve helps to return the majority of operated on patients to active live patterns. Improvements of the patients' state within 5 years after surgery was recorded in 58 cases, 9 patients died within 2 to 34 months. Actuarial statistics showed that the 5-year survival rate comprised 75.9% following prosthetic mitral valve replacement.

[Clinical course of mitral insufficiency after commissurotomy]. / Klinika i techenie mitral'noi nedostatochnosti posle komissurotomii

In 172 patients in whom transventricular mitral commissurotomy had been complicated by the development of post-operative regurgitation the immediate and remote results of the surgery were studied. Among patients with mitral incompetence a complicated post-operative period with regurgitation of the I degree was registered in 51 per cent of the cases, with the II degree-in 73 and with the III-in 100 per cent of the patients. The principal complications included cardiac insufficiency and various derangements of the cardiac rhythm. The nature of cardiac insufficiency depended upon the degree of emerging regurgitation. A study of such patients over periods from 1 to 10 years after surgery proved good and satisfactory results to be recorded more seldom than in the case of an adequate commissurotomy and that they are dependent upon the degree of regurgitation. In the event of mitral incompetence of the II degree an urgent surgical correction of the defect is indicated. In need for operative treatment are also patients with mitral incompetence of the II degree with a possible progressive decompensation of the circulation.