QUALITY OF LIFE CHANGES AFTER PAND PROCEDURE IN PATIENTS WITH MITRAL VALVE PATHOLOGY COMPLICATED BY ATRIAL FIBRILLATION AND HIGH PULMONARY HYPERTENSION

The study aimed to analyze the effectiveness of circular sympathetic denervation of pulmonary trunk and arteries mouths in patients with mitral valve dysfunction, complicated by atrial fibrillation and high pulmonary hypertension, as well as to reveal the influence on the change of quality of life of these patients. We have analyzed the results of surgical treatment of 202 patients with mitral defect accompanied by atrial fibrillation and high pulmonary hypertension (more than 40 mm Hg). Operative treatment in these patients included surgical correction of mitral valve defect - prosthesis or reconstruction of native valve - the first group of patients (n-62). Surgical correction of atrial fibrillation and pulmonary hypertension in this group of patients was not performed. Patients of the second group (n-89) underwent correction of mitral defect with the subsequent biatrial radiofrequency ablation using Maze IV scheme with the application of Atri Cure bipolar ablator under transmularity control. A complex intervention including elimination of mitral valve defect, Maze IV procedure and circular denervation of pulmonary trunk and pulmonary arteries mouths (Pulmonary Artery Denervation - PADN) was conducted on the patients of the third group (n-51).PADN is an effective and safe method of surgical treatment for high secondary pulmonary hypertension. It promotes b ack remodeling of heart cavities, in particular left atrium (p-0.01), normalization of pulmonary hypertension and reduction of heart failure (p=0.023).Complex surgical treatment of patients with mitral defect, atrial fibrillation and high pulmonary hypertension significantly improves the results of Maze IV procedure by restoration and creation of sinus rhythm in 3-month’s time after surgery (p=0.008).

вторичная легочная гипертензия, абляция легочного ствола, денервация ганглионарных сплетений, митральный порок, фибрилляция предсердий, secondary pulmonary hypertension, pulmonary trunk ablation, denervation of ganglionated plexuse, mitral defect, atrial fibrillation