PRELIMINARY ASSESSMENT OF RHYTHM AND CONDUCTION DISTURBANCES IN THE EARLY POSTOPERATIVE PERIOD WITH VARIOUS TYPES OF AORTIC VALVE SURGERY WITH A NARROW FIBROUS RING

Objective: To evaluate the arrhythmias and conduction disturbances that arose during aortic valve replacement in patients with aortic stenosis and a narrow fibrous ring. Material and methods: The cases of aortic valve prosthetics with a narrow fibrous ring were analyzed: 52 cases of bioprosthetics of the aortic valve with a standard prosthesis of size 19 and 21, 21 cases of prosthetics with an aortic allograft in patients with an aortic ring 17-21 mm, 22 cases of implantation of prostheses quickly deploying Perceval with a narrow fibrous ring (19-21 mm), 11 cases of bioprosthetics of the valves with a ring size of 19-21 mm. Results: Hospital mortality was observed in the group of allografts and amounted to 4.7% (1 case). The most common complications in the early postoperative period were rhythm disturbances: the standard prosthetics group - rhythm disturbances, which required the setting of a pacemaker 7.7%, atrial fibrillation paroxysms 19.2%. In the group of aortic allografts - 9.5 and 28.6%, respectively. In the Perceval group - 9.1 and 22.7%, respectively. In the group of bioprosthetics of the valves of arrhythmic complications requiring implantation, pacemaker was not observed. Conclusions: Rhythm disturbances (including those requiring implantation of pacemaker) were observed in all the groups except for the bioprosthetics of the aortic valve leaflets, possibly due to the lack of “load” on the aortic valve ring. However, to obtain more accurate results, a further set and observation of the studied groups is required.The introduction of “new” methods of aortic valve replacement and the assessment of possible complications provides the possibility of a differentiated approach to the choice of treatment method depending on the severity of the patient's initial condition and will achieve good direct results in patients with a narrow fibrous ring and a high risk of surgical treatment.