MITRAL VALVE REPLACEMENT OF FULL FORM ATRIOVENTRICULAR CANAL. INFLUENCE OF THE SIZE OF THE PROSTHESIS ON THE RESULTS OF CORRECTION
Introduction. At the same seat size artificial heart valve prostheses difference in diameter orifice for prostheses of different manufacturers can be substantial. According to the literature, these dimensions may differ by from 2.1 mm to 4.3 mm. Moreover, the difference fitment and inner diameters of prosthetic heart valves requires a mandatory parameter calculation according to the purpose of optimizing the choice of prosthesis in children. Objective. To present the experiences of the mitral prosthesis with a total atrioventricular canal, the criteria for selection of the prosthesis size and risk factors of hospital mortality. Material and methods. The study included 35 patients with the complete form of atrioventricular canal, which from 2000 to 2012 year was performed mitral valve. The age of patients at the time of operation ranged from 4 months to 27 years median age was 20 months. Median body weight of patients was 18.5 kg (3.9 to 43 kg). In our series of observation data analysis performed on a number of criteria ( Z-score, reflecting the ratio of the diameter of the mitral orifice diameter of the prosthesis to the mitral valve in the normal ratio of bore diameter of the mitral valve prosthesis to the body weight of the child and the ratio of the diameter of the planting of the mitral valve prosthesis to the surface area patient's body). For each of the criteria, all patients were divided into different groups. Results. There was no deaths among patients with a Z-score value mitral prosthesis from -2 to 0, a ratio of the size of the prosthesis to the fitment body weight ≤2 mm/kg, with the ratio of the size of the landing area surface of the prosthesis to the body 40 mm/m 2. The frequency of non-fatal complications in these same patients was 9%. Patients with a Z-score value mitral prosthesis over 2, with a ratio of the size of the prosthesis to the fitment body weight was greater than 2 mm/kg, and a ratio of the size of the landing area surface of the prosthesis with a body 40 of non-lethal complication mm/m2 frequency exceeded 30%, and hospital mortality was about 16%. Conclusion. Mitral valve prosthesis selection in patients with complete form of atrioventricular canal should be considered optimal if the Z-score of -2 to 0, the ratio of the diameter of the planting of prosthesis to body weight ≤ 2 mm/kg attitude bore diameter of the prosthesis to the patient body surface area ≤40 mm/m 2.