SURGICAL METHODS OF TREATMENT OF END-STAGE HEART FAILURE

The aim of the study is to establish the effectiveness of mechanical support of blood circulation of patients with end-stage heart failure depending on the method of surgical correction. The results of the study are based on the data of examination and dynamic observation of 73 patients (median age 44 (16-69) years, men 68 patients, women 5 patients) who were treated from 2008-2019 іn the following medical institutions: Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of Cardiac Surgery on the Basis of KL «Feofania» DUS. Patients were examined during the initial examination, after 3 months and after a year. The results of surgical treatment of patients with critical heart disease insufficiency: after direct UTS: 24 (92%) patients were treated with positive result, 2 (8%) patients died. There were 18 (46%) patients performed secondary UTS, patients who were on LVAD therapy. 18 (46%) patients who continue LVAD therapy. On LVAD-therapy 3 (8%) patients died. The cause of death is purulent-septic lesions. Which patients were on BiVAD - therapy: secondary UTS performed 4 patients (50%). 4 (50%) patients died on BIVAD therapy. The cause of death in 2 (50%)cases of purulent-septic lesions, and in 2 (50%) cases it is an organ field insufficiency. Analysis of the results of the differential approach to surgical treatment patients with heart failure III-IV FC according to NYHA: patients with critical heart failure in the presence of contraindications to direct transplantation heart rate, it is advisable to consider the use of long-term mechanical circulatory support based on LVAD therapy (p<0001) and BiVAD - therapy (p<0001) as a mechanical bridge to heart transplantation. Applied long-term mechanical support of blood circulation in patients with high indicators of pulmonary hypertension (p<0001), allows to normalize the pressure in the pulmonary artery and consider performing a secondary heart transplant.