COMPARATIVE ANALYSIS OF ECHOCARDIOGRAPHIC PARAMETERS OF HOMOGRAFT AND NATIVE HEART VALVES

Komarov Roman Nikolaevich, Tkachev Maksim Igorevich, Zaikina Natalia Viktorovna, Zaikina Margarita Pavlovna, Varlamov Georgy Arkadievich, Gailaev Ilyas Danilbekovich, Choibsonov Nima-Surun Tsyren-Dashievich, Maisyan Tigran Artemovich

Introduction. Despite the widespread use of homograft valves in valve surgery, their medium-term results remain insufficiently studied. In particular, there is a lack of systematized data on their echocardiographic characteristics at various periods post-implantation, as well as a comparative analysis with the indicators of healthy patients. This limits the understanding of degeneration processes and factors influencing the durability of the grafts. Objective. To assess the medium-term echocardiographic parameters of homograft valves in different positions using transthoracic echocardiography and compare them with the values of healthy volunteers. Materials and Methods. The study included 35 patients who underwent homograft implantation in the aortic, mitral, and tricuspid positions, as well as 68 healthy volunteers in the control group. The mean follow-up period was 6.8 ± 1.41 years. The parameters assessed included end-diastolic size (EDV), end-systolic size (ESV), left ventricular mass (LVM), end-diastolic (EDV) and end-systolic volume (ESV), as well as the morphometric characteristics of the atria. Additionally, the thickness of the interventricular septum (IVS), posterior wall of the left ventricle (LVPW), ejection fraction (EF), diameters of the Valsalva sinuses, and ascending aorta were analyzed. Results. Patients with aortic homografts (group I, n=19, mean age 50.0 ± 16.4 years), mitral homografts in the mitral position (group II, n=6, mean age 47.5 ± 13.1 years), and mitral homografts in the tricuspid position (group III, n=10, mean age 46.3 ± 14.9 years) showed satisfactory hemodynamic indicators in the medium-term period. When compared to the control group (n=68, mean age 54.5 ± 13.1 years), statistically significant differences were found in the degree of aortic regurgitation and pressure gradients on the mitral homograft, but these parameters remained within clinically acceptable values. The degree of regurgitation on the mitral homograft in the tricuspid position was borderline, likely due to the anatomical features of the valve and its subvalvular structures. The results confirm the functional integrity of homografts in the studied positions in the medium-term follow-up period. Conclusion. The medium-term results of homograft valve use in the aortic, mitral, and tricuspid positions confirm their functional integrity. Despite some differences in echocardiographic parameters, all values remain within clinically acceptable ranges, indicating the stability of the grafts.

Keywords:homograft valves, echocardiography, mitral homograft, aortic homograft, tricuspid position