[Rhythm disorders and their correction in connection with mitral valve prosthesis].

The course of the operative procedure of mitral valve prosthetic replacement was analyzed in 180 cases. All patients during perfusion developed certain disorders in the processes of excitation and myocardium conductivity that manifested themselves in different kinds of arrhythmias. In 23 cases ventricular fibrillation was recorded during the intervention, in 4 cases--a full atrioventricular block. The main causes of the severe arrhythmias consisted in coronary circulation disorders caused by temporary cross-damping of the aorta, air embolism, inadequacy of the perfusion, compression of the circumflex branch of the left coronary artery by a ligature or haematoma. Severe rhythm disorders usually occurred in patients with cardiomegaly and distinct dystrophic changes in the myocardium. Electric defibrillation was conducted after mitral valve prosthetic replacement in 57 patients for the management of chronic cardiac fibrillation, a positive effect being achieved in 47 of them. The most reasonable period for electroimpulse therapy in patients with IIA stage of circulation disorders is 3-4 weeks after surgery, while in those with IIB stage--5-6 months therafter.