LATE RESULTS OF MITRAL VALVE REPAIR IN ADULTS WITH SEPTAL DEFECTS

Objective. To present the long-term results of mitral valve repair in adult patients with atrial or ventricular septal defects. Material and methods. The study included 25 patients aged from 16 to 61 years operated for septal defects and mitral insufficiency in 2000-2014. Seventeen (68%) patients had secondary atrial septal defects (in one of them there was a partial anomalous drainage of pulmonary veins), and in 8 (32%) cases there was ventricular septal defect. According to echocardiography, mitral insufficiency was assigned to Carpentier type 1 and had 2nd degree in 12 (48%) patients, 3rd degree in 12 (48%) patients, and 4th degree in 1 (4%) patient. Suture annuloplasty was performed in 10 (40%) patients, annuloplasty with the support ring (including the PTFE band) - in 8 (32%), multicomponent reconstitution - in 5 (20%), and Alfieri repair - in 2 (8%) patients. The concomitant procedures were tricuspid valve plastic in 9 cases and maze procedure in 3 cases. Results. Hospital mortality was zero. The mean follow-up period was 60 ± 11 months (5 years). Cardiac lethality is 0%, mitral insufficiency is regarded as minimal or 1st degree in 21 (84%) cases, 2nd degree - in 4 (16%) cases. All patients have I-II NYHA class. Conclusion. In all cases, the leading cause of mitral insufficiency was dilatation of the fibrous ring due to prolonged overload of the pulmonary circulation. Mitral valve repair in various modifications is an effective strategy with good long-term results.

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