[Surgical treatment of mitral stenosis complicated by massive thrombosis of the left atrium].

V. Popov
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Abstract

Objective. To analyze the peculiarities of surgical treatment of a mitral stenosis, complicated by massive thrombosis of left atrium. Маterials and methods. The group analyzed, operated in the Institute, consisted of 344 patients. Thrombosis of left atrium was considered a massive, when thrombotic masses have occupied no less than one third of its volume, not mentioning an auricle of atrium. Results. Hospital lethality after change of a mitral valve have constituted 4.2% and directly depended on from a degree of the left atrium thrombosis (р < 0.05). After open mitral comissurotomy hospital lethality was not observed, witnessing the expediency of the thrombosis matrix extraction. Conclusion. During the operation for a massive thrombosis of left atrium it is important to remove a maternal base of thrombotic bed and to eliminate the left atrium auricle, what lowers essentially the risk for lethality and thromboembolic complications on a hospital stage. Doing preoperative computed tomography of head and abdominal organs constitutes obligatory condition for exclusion of a hidden thromboembolism occurrence.
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二尖瓣狭窄合并左心房血栓形成的外科治疗
目标。目的分析二尖瓣狭窄合并左心房血栓形成的外科治疗特点。Маterials和方法。本组共344例患者。当血栓块不少于左心房体积的三分之一时,即认为左心房血栓形成,更不用说心房的耳廓了。结果。二尖瓣置换术后的医院死亡率为4.2%,与左心房血栓形成程度直接相关(p < 0.05)。开放性二尖瓣合拢切开术后未见致死性,可见血栓基质提取的便捷性。结论。在左心房大量血栓形成的手术过程中,重要的是移除血栓床的母体基础和消除左心房耳廓,这从根本上降低了医院阶段的死亡率和血栓栓塞并发症的风险。术前对头部和腹部器官进行计算机断层扫描是排除隐性血栓栓塞发生的必要条件。
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[MEDIASTINAL LEIOMYOMA]. [Surgical treatment of mitral stenosis complicated by massive thrombosis of the left atrium]. [Development of clinical physiology in heart surgery]. [Central hemodynamics during correction of acquired aortic defects without artificial blood circulation]. [Angiocardiographic and echocardiographic diagnosis of complete transposition of great vessels in association with pathology of the aorta].
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