Authors
Sazonenkov m.A.1, 2, Moskalev A.S.1, Tatarintsev A.M.1, Ismatov h.H.2, Moskaleva d.D.2
1 Belgorod Regional Clinical Hospital, Belgorod
2 Belgorod National Research University, Belgorod
Abstract
Background. Mitral valve disease is one of the main diagnoses operated on in cardiac surgery at the present time. There are a number of etiological causes of mitral valve disease that require correction. The distribution of etiologies, methods of valve correction, and the results of operations change with the growth of surgical practice.
Purpose. To study all cases of surgical treatment of mitral valve disease in the cardiac surgery department of Belgorod for the period of 2015-2024. To identify the main pathologies, their distribution, and changes in surgical techniques over the selected period.
Methods. In the cardiac surgery department of the St. Joasaph Regional Hospital, an average of 490 heart surgeries were performed per year over the selected 10-year period. Of these, 51–84 cases involved surgical correction of mitral valve defects. In total, 582 cases of mitral valve defects were treated during the period from January 1, 2015 to December 31, 2024. The etiology of the defect is diverse: degenerative mitral valve insufficiency (DMI), chronic rheumatic disease, secondary damage in coronary artery disease (CAD), infectious endocarditis (IE), hypertrophic obstructive cardiomyopathy (HOKM). The method of correction was taken into account: valve prosthesis or reconstruction.
Results. The first place in the etiology of the defect was occupied by degenerative insufficiency of the MK, the second – CRBS, the third – secondary damage of the valve in CAD, the fourth – IE, the fifth – HOKM. During the selected period, the proportion of degenerative mitral insufficiency (DMI) was 40.5% to 64.5% per year, with an average of 50.86%. The proportion of operated CHF was 6.3% to 23.6%, with an average of 17.52%. Ischemic mitral insufficiency occurred in 30.8% to 5.7%, with an average of 13.92%. Operations for infectious endocarditis were performed in 3.2% to 13.6% of cases, with an average of 9.62%. Corrections of the mitral valve defect in HCMF were performed in 1.9% to 13.4% of cases, with an average of 8.06%. During the follow-up period, there was a decrease in the frequency of correction of mitral valve insufficiency in IHD and an increase in the frequency of correction in CRBS. The share and variety of reconstructive techniques used have increased significantly.
Conclusion. During the selected period of time 2015–2024, the number and proportion of cases of surgical correction of mitral valve disease remain relatively constant. The proportions of the frequency of etiologies of operations on the MK obtained by us correspond to the global practice. The expansion of the frequency of use and complexity of the valve reconstructions used did not lead to a decrease in the quality of the results.
Keywords: mitral valve lesion, etiology, methods of surgical correction, reconstructive operations.
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