[Surgical correction of multivalvular defects in patients who had earlier undergone heart surgery].

The article analyses the results of surgical treatment of 45 patients with multivalvular acquired heart diseases which had been previously treated by operation. Stage III (terminal) circulatory disorders were diagnosed in 11 (24.1%) patients. A pathological condition of the tricuspid valve was found in almost all patients with the terminal stage of circulatory disorders. Eleven (24.4%) patients died after the operation. The most frequent causes of the fatal outcomes were: cardiac failure (in 6 patients) and hemorrhage (in 2 patients during the operation and in 1 patients on the 6th post-operative day; the bleeding occurred from varicose veins of the stomach and esophagus). Severe initial circulatory insufficiency was the main factor of operative risk. The criteria of operability must be elaborated for this contingent of patients suffering from severe cardiac insufficiency on the eve of the operation.