OBJECTIVE

To evaluate the long-term results of surgical correction of multivalvular heart defects.

MATERIAL AND METHODS

In the department of heart defects surgery, 51 patients underwent replacement of two or more heart valves between 2023 and 2025. In the long-term period, which averaged 19.5±6.3 (9±29) months, 47 patients were examined. Survival was evaluated at the primary endpoint. Functional state by the NYHA, lack of thromboembolic and hemorrhagic complications, heart remodeling and intracardiac hemodynamics according to the echocardiography data, as well as metabolic, cardiovascular indices, parameters of lung ventilation and pulmonary gas exchange according to the data of ergospirometry were assessed at the secondary endpoint.

RESULTS

The long-term actuarial survival amounted to 92.5%. Massive gastric hemorrhage due to an anticoagulant overdose was the cause of one fatal case. A clinically significant health improvement has been noted in the majority of patients; functional class I (FC) by the NYHA has been noted in 17 patients (37.5%), FC II by the NYHA — in 25 (54%), FC III by the NYHA — in 4 (8.5%). The absence of hemorrhagic complications by Kaplan-Meyer amounted to 95%, there were no episodes of thromboembolism. According to the ergospirometry, mean values of exercise tolerance and peak oxygen consumption reached 102.1±22.5 W and 15.6±3.4 ml/kg/min, respectively.

CONCLUSION

Surgical correction of multivalvular heart defects allows to significantly improve the intracardiac hemodynamics, survival and functional status in the long-term period as the only effective treatment method for patients in this particularly complex category.