LONG-TERM RESULTS OF SURGICAL TREATMENT OF AORTIC DEFECTS IN ELDERLY PATIENTS
The aim of the study was to conduct a comparative analysis of complications in the late postoperative period in patients with aortic valve stenosis who underwent transcatheter aortic valve replacement or aortic valve replacement with biological prostheses. Materials and Methods. The authors carried out a comprehensive physical examination of 251 patients with aortic stenosis. Group I included 128 patients who underwent transcatheter aortic valve replacement. Besides, Group I was divided into two subgroups. Subgroup A consisted of 56 patients. They had contradictions for aortic valve replacement in a standard open way with assisted circulation due to the severity of the underlying disease, comorbidity and severity of cardiovascular insufficiency (EuroSCORE II over 20 % and STS SCORE over 10 %). Subgroup B consisted of 72 patients with a risk of poor outcome after surgical intervention (EuroSCORE II less than 20 % and STS SCORE less than 10 %). Patients of Group II (n=123) were comparable to subgroup B by the severity of the underlying disease (EuroSCORE II less than 20 % and STS SCORE less than 10 %). All patients in Group II underwent aortic valve replacement under assisted circulation. Results. In Subgroup A, the authors observed the following complications: few events of cerebral insufficiency and acute prosthetic infective endocarditis; in subgroup B - persistent atrial fibrillation and acute myocardial infarction. In Group II the most common complications were primary atrial fibrillation and acute myocardial infarction. However, their frequency was 2.6 (p=0.0001) and 1.7 times (p=0.0014) as frequent as in Subgroup B. In addition, in Group II, the authors observed sternum instability (2.4 %) and ascending aorta aneurysm (2.4 %). Conclusions. In Subgroup A, the incidence of complications in the late postoperative period was 10.7 %, in Subgroup B - 5.6 %, and in Group II - 30.9 %. Those were mainly cardiovascular complications.