Candidate: Pulatov Oleg Karimovich

Degree Sought: Doctor of Philosophy (PhD) in Medical Sciences, Specialty: 14.00.34 – "Cardiovascular Surgery"

Dissertation Title: "Evaluation of the Results of Left Atrial Volume Reduction (Atrioplasty) in Acquired Heart Valve Diseases"

Scientific Advisor: D.Sc. Turayev Feruz Fatxullayevich

Institution: Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V. Vakhidov (Tashkent, Uzbekistan)

Key Findings and Outcomes

1. Objective:

   To evaluate the effectiveness of left atrial volume reduction (atrioplasty) techniques in the surgical correction of valvular heart disease complicated by left atrial atriomegaly, and to develop strategies for improving surgical outcomes.

2. Scientific Novelty:

   • Differentiated Approach: A tailored selection criterion was established: the Kawazoe technique is indicated when the para-annular segment of the left atrium is dilated beyond 5.0–6.0 cm, whereas the Mercedes method is recommended when combined with a distance >5.0 cm between the pulmonary vein ostia.

   • Hemodynamic and Rhythm Improvements: Left atrial atrioplasty restores normal geometric configuration, stabilizes intracardiac hemodynamics, reliably recovers sinus rhythm, and reduces the risk of low cardiac output syndrome.

3. Clinical and Economic Impact:

   • Shorter Hospital Stay: Patients who underwent atrioplasty experienced faster recovery, reducing total hospital stay from an average of 10 days to 7 days.

   • Long-Term Survival: Long-term follow-up (average 13 years) demonstrated stable sinus rhythm maintenance in 62.6% of patients and an overall 10-year survival rate of 85–88%.

   • Cost Efficiency: Preventing postoperative complications and reducing intensive care unit duration yielded an average budget saving of 256.5 million UZS per 30 patients.