PREDICTION OF THE RISK OF INFECTIOUS ENDOCARDITIS IN HEART VALVE BIOPROSTHESES WITH SIGNS OF ENDOTHELIAL MONOLAYER INTEGRITY VIOLATION

Objective of the work : conducting a histological study of heart valve bioprostheses (HVB) with varying degrees of structural abnormalities to identify key mechanisms of infective endocarditis (IE) pathogenesis and determine morphological predictors of its development. Methods and materials of the study . In this work, a comparative analysis of three groups of explanted xenopericardial bioprosthetic heart valves (BHVs) of the aortic and mitral positions, differing in the degree of preservation of the endothelial coating and the structure of the stromal leaflets was performed: 1. Intact BHVs (control group). 2. BHVs with minimal structural damage. 3. BHVs with pronounced destructive changes. Results . Against the background of a tendency to increase the number of patients with implanted BHVs for acquired heart defects (AHDs) and a statistically significant increase in antibiotic resistance of pathogenic microorganisms, cases of IE of bioprostheses of various etiologies are becoming an increasingly frequent and formidable complication. Infective endocarditis of bioprosthetic heart valves is a serious complication initiated, as a rule, by a violation of the integrity of the endothelial monolayer, which performs barrier and thromboresistant functions. In recent years, there has been a steady increase in the number of patients with prosthetic valves, which, combined with the global problem of antibiotic resistance, makes the study of IE of the BCS particularly relevant. This study focuses on a detailed analysis of the histological features of bioprostheses demonstrating varying degrees of degenerative changes in order to identify morphological patterns associated with the development of this pathology. Conclusion . A deep analysis of structural rearrangements of the BCS tissue will not only predict the risk of developing infective endocarditis, but also identify key factors that determine the vulnerability of prostheses to microbial colonization and subsequent infectious complications.