[Late results of closed methods of the surgical treatment of multiple valvular rheumatic heart defects].

The late results of surgical treatment of 178 patients with follow-up periods of 6 months to 8 years are analysed. The late results were much worse in stage IV disease, marked calcinosis of the valves, concomitant mitral or tricuspid regurgitation, intraatrial thrombosis, as well as in cases with a combination of these complications. Analysis of the actuarial curve showed that unfavourable dynamics of the remote outcomes were usually associated with inadequate aortic or tricuspid commissurotomy. It is underscored that a change in the surgical tactics in the direction of aortic valve prosthetics and correction of tricuspid valve defects and complicated forms of mitral stenosis under conditions of extracorporeal circulation is necessary.