Purpose. To assess the disorders of the cardiac conduction system (CCS) that occurred in the early postoperative period after aortic valve (AV) replacement by the Ozaki method.Methods. The study included 256 patients after a successfully performed Ozaki procedure. Patients with a history of open cardiac surgery, with an implanted pacemaker, with permanent atrial fibrillation, with simultaneous Ozaki surgery with correction of another pathology, in case of repeated surgery on AV in the next six months, with lethal outcome, under the age of 18 years, when it is impossible to analyze the CCS dynamics were excluded. The mean age was 57.9±11.1 years, the male sex was 119 people (46.5%), the body mass index was 29.7±5.5 kg/m2 , diabetes was observed in 40 patients (15.6%), anamnesis of CCS disorders in 10 (3.9%), CCS disorders on the baseline electrocardiogram (ECG) in 32 (12.5%). Conduction abnormalities were assessed according to the anamnesis and the results of daily ECG recording.Results. In the early postoperative period, CCS disorders were registered in 35 patients (13.7%), of whom 27 (10.6%) had their first occurrence, and 8 (3.1%) had previously existed. By the time of discharge, persistent CCS disorders (which occurred for the first time and in the case of progression of pre-existing blocks) remained in 11 (4.3%): 8 (3.1%) had bundle branch blocks, 3 (1.2%) had atrioventricular blocks that required implantation of a permanent pacemaker. Patients with pacemaker had initial conduction abnormalities. The most frequent dysfunction of the CСS was the left bundle branch block (LBBB) (45.5%). We analyzed 14 variables as predictors of the onset or progression of persistent CCS disorders. Two independent predictors were identified - the presence of conduction abnormalities on the baseline ECG and the time of cardiopulmonary bypass. In patients with persistent conduction disturbances in the postoperative period, CCS disorders on the baseline ECG were more common - 36.4% compared with patients without CCS disorders after surgery - 11.4% (p=0.035) and there was a longer duration of cardiopulmonary bypass 140.6±41.1 min. and 122.4±26.1 min. respectively (p=0.03).Conclusion. The most frequent disorder of the conduction was the LBBB. None of the first dysfunctions of CCS led to the implantation of the pacemaker. The presence of initial ECG conduction disturbances and the time of cardiopulmonary
<p><strong>Aim.</strong> The study aimed to compare the hydrodynamic characteristics and durability of the aortic root prosthesis with pericardial cusps with various options for the formation of commissures.</p><p><strong>Methods.</strong> Nine conduits with pericardial valves were formed according to the technique described by Ozaki. The prostheses were divided into 3 groups of 3 specimens each: group 1 — without additional reinforcing seams on the top of the commissure; group 2 — with an additional U-shaped seam without gasket; and group 3 — with an additional suture with an opposite pericardial gasket. The prostheses were fixed on a stand for hydrodynamic testing of artificial heart valves. The hydrodynamic characteristics of the prostheses were evaluated. The hydrodynamics of the frame biological prosthesis was used for comparison. After assessing the hydrodynamic parameters of the aortic root prostheses, their work durability was tested. Defects of the pericardial cusps were studied macroscopically.</p><p><strong>Results. </strong>Two samples from group 2 were withdrawn from testing ahead of schedule at around 11 × 10<sup>6</sup> cycles, which is approximately 3.5 months of normal heart function. The other prostheses remained competent and were removed for an examination at 32 × 10<sup>6</sup> cycles, which is approximately 9.6 months of normal heart function.</p><p><strong>Conclusion. </strong>The hydrodynamics of the aortic root prosthesis with pericardial valves was comparable to the hydrodynamics of the frame biological prosthesis. Additional U-shaped sutures in the commissure area of the pericardial cusps did not increase the functional durability of the aortic root prosthesis with pericardial leaflets and served as additional risk factors for leaflet perforation. Implantation of pericardial leaflets into a vascular graft resulted in a different distribution of dynamic stress compared to the original aortic valve neocuspidisation, which preserved the aortic root.</p><p>Received 8 July 2021. Revised 30 August 2021. Accepted 7 September 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Contribution of the authors<br /> </strong>Conception and study design: V.V. Bazylev, P.A. Batrakov<br /> Data collection and analysis: P.A. Batrakov, D.M. Khadiev, A.A. Egorov, N.A. Eremin<br /> Drafting the article: P.A. Batrakov<br /> Critical revision of the article: V.V. Bazylev, P.A. Batrakov<br /> Final approval of the version to be published: V.V. Bazylev, P.A. Batrakov, D.M. Khadiev, A.A. Egorov, N.A. Eremin<strong> </strong></p>
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