Abstract
The case of successful surgical treatment of a patient with calcined aortic stenosis of degenerative
genesis and marked decrease myocardial contractile function using two-stage procedure was
described. Initially, the patient had phenomena of heart failure with features of decompensation
in both circulations, resistant to active conservative therapy. Thus, the first stage was the performance
of endovascular surgery by transluminal balloon valvuloplasty of the aortic valve. The satisfactory
effect was noticed that allowed performing correction of valve pathology under cardiopulmonary
bypass - aortic valve replacement, reconstructive intervention on the mitral and
tricuspid valve. There were no complications in postoperative period. The result of treatment is
satisfactory that is confirmed by the data. This treatment, if clinically indicated is recommended
to use for extremely complicated category of patients with critical aortic stenosis combined
with decrease myocardial contractile function of the left ventricle.
References
Borowski A., Ghodsizad A., Vchivkov I., Gams E. Surgery for severe aortic stenosis with low transvalvular gradient and poor left ventricular function - a single centre experience and review of the literature // J. Cardiothorac. Surg. 2007. Vol. 31. P. 2-9.
Burwash I. G. Low-flow, low-gradient aortic stenosis: from evaluation to treatment // Curr. Opin. Cardiol. 2007. Vol. 22. P. 84-91.
Dymond D. S., Wolf F. G., Schmidt D. H. Severe left ventricular dysfunction in critical aortic stenosis - reversal following aortic valve replacement // Postgrad. Med. J. 1983. Vol. 59. P. 781-783.
Flores-Mar
Masson J. B., Kovac J., Schuler G. et al. Transcatheter aortic valve implantation: review of the nature, management, and avoidance of procedural complications // JACC. Cardiovasc. Interv. 2009. Vol. 2. P. 811-820.
Mookadam F., Moustafa S. E., Khandheria B. Management of aortic valve disease in the presence of left ventricular dysfunction // Expert. Rev. Cardiovasc. Ther. 2010. Vol. 8. P. 259-268.
Mutlak D., Aronson D., Lessick J. et al. Frequency, characteristics, and outcome of patients with aortic stenosis, left ventricular dysfunction, and high (versus low) trans-aortic pressure gradient // Med. Assoc. J. 2010. Vol. 12. P. 563-567.
Ozkan A., Kapadia S., Tuzcu M., Marwick T. H. Assessment of left ventricular function in aortic stenosis // Nat. Rev. Cardiol. 2011. Vol. 14. P. 494-501.
Scharmer U. Surgical replacement or transcatheter implantation: how decisions should be made in aorticstenosis? // Dtsch. Med. Wochenschr. 2011. Vol. 136. P. 2106-2108.
