COMPARATIVE ANALYSIS OF IMMEDIATE AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH MITRAL DEFECTS AND ATRIOMEGALIA
DOI:
https://doi.org/10.32689/2663-0672-2025-3-3Keywords:
Mitral valve prosthesis, left atrial appendage plastic surgery, left atrial appendage resection, immediate results, long-term resultsAbstract
In this article, the scientific problem is focused on studying the immediate and long-term results of surgical treatment of patients with one of the most common heart defects – mitral valve pathology and the presence of atriomegaly. A detailed review of modern scientific studies was conducted to study the existing world experience of the influence of the presence of atriomegaly on the clinical course of mitral valve disease and the effectiveness of surgical treatment at different times depending on the volume of surgical correction. Aim. The aim of the work is to study the effectiveness of surgical treatment of patients with mitral heart defects and atriomegaly by conducting a comparative analysis of results at different times (immediate and long-term). Scientific novelty. For the first time, a study of the effectiveness of surgical treatment of patients with mitral heart defects and atriomegaly was conducted on a large sample of patients over time. Materials and methods: The study included patients with mitral heart defects (stenosis, insufficiency), (n=656). All patients in the study underwent surgical correction of mitral defect (mitral valve prosthesis), and only patients from the main group underwent surgical correction of the volume of the left atrium with resection of its appendage. The material for analysis was data from medical documentation: extracts from the medical history, operation protocols, data from clinical and instrumental examination during dispensary observation. Conclusions. Studying the effectiveness of surgical treatment in the immediate term and in the dynamics of long-term recovery after correction of mitral valve defect and atriomegaly is important, as it allows objectively assessing different approaches in the application of plastic techniques for correction of the left atrium with resection of its appendage. It was found that in patients from the main group, performing plastic surgery of the left atrium with resection of its appendage increased the effectiveness of surgical treatment by 3.42 times in the early postoperative period, as evidenced by a significantly higher frequency of "good" results (OR=3.42; p=0.0001, χ2=56.39). It was also determined that the “good” results of surgical treatment in the long term were also significantly higher in patients of the main group, in whom the effectiveness was 2.69 times higher (OR=2.69; p=0.0001, χ2=35.36), compared to patients who underwent only mitral valve replacement without correction of atriomegaly.
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