Pub Date : 2023-06-30DOI: 10.21688/1681-3472-2023-2-27-34
O. Kamenskaya, I. Loginova, A. Klinkova, S. S. Porotnikova, E. Samoilova, V. Tihomirov, S. Krasilnikov, V. Lomivorotov, A. Chernyavsky
Background: The respiratory system is negatively affected by radiation exposure during the comprehensive treatment of breast cancer (BC), which has an effect on the treatment effectiveness and patients’ quality of life.Objective: To evaluate changes in pulmonary ventilation and diffusion characteristics and ventilation effectiveness in patients with BC before and after radiation therapy (RT).Methods: Our prospective cohort study included 232 women with BC admitted to the Meshalkin National Medical Research Center for an adjuvant RT after surgical treatment. Before and after the RT we conducted pulmonary function tests: body plethysmography, lung diffusion capacity testing, and cardiopulmonary exercise testing with measurement of peak oxygen consumption. We used multivariate regression analysis to determine predictors of pulmonary function decline during RT (decrease in the lung diffusion capacity > 5% compared with baseline).Results: Pulmonary function tests prior to RT demonstrated that 15% of the patients with BC had pulmonary ventilation disorders, and 25% of the patients had pulmonary gas exchange abnormalities (most of them were newly diagnosed). In the general group following RT, we saw a significant decrease in the lung diffusion capacity (P = .044) and an increased incidence of obstructive breathing patterns among the examined patients (P = .036). Other pulmonary ventilation parameters, its effectiveness, and reserve capacity of the respiratory system after RT did not change significantly in the study group and corresponded to the reference values. The postradiation pulmonary function was negatively affected by the reduced level of pulmonary diffusion capacity at baseline (≤ 70% of the reference value) [OR 1.15 (1.03-1.34), P = .004], abnormal breathing pattern prior to RT [OR 1.08 (1.01-1.15), P = .029], involvement of regional lymph nodes (N1-3) [OR 1.10 (1.04-1.26), P = .003].Conclusion: Early postradiation respiratory disorders in patients with BC are marked by a decrease in the lung diffusion capacity and an increased incidence of obstructive patterns of pulmonary ventilation. The factors negatively affecting changes in pulmonary ventilation and diffusion characteristics after RT were the baseline pulmonary gas exchange disorders, obstructive breathing pattern prior to RT, and radiation exposure to lymph nodes. Received 28 December 2022. Revised 26 May 2023. Accepted 30 May 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: O.V. Kamenskaya, V.V. Lomivorotov Data collection and analysis: S.S. Porotnikova, E.A. Samoilova, V.G. Tihomirov Statistical analysis: I.Yu. Loginova, A.S. Klinkova Drafting the article: I.Yu. Loginova, O.V. Kamenskaya Critical revision of the article: S.E. Krasilnikov, A.M. Chernyavskiy Final approval of the version to be published: O.V. Kamenskaya, I.Yu. Loginova, A.S. Klinkova, S.S. Porotni
{"title":"Changes in pulmonary function in patients with breast cancer before and after radiation therapy","authors":"O. Kamenskaya, I. Loginova, A. Klinkova, S. S. Porotnikova, E. Samoilova, V. Tihomirov, S. Krasilnikov, V. Lomivorotov, A. Chernyavsky","doi":"10.21688/1681-3472-2023-2-27-34","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-2-27-34","url":null,"abstract":"Background: The respiratory system is negatively affected by radiation exposure during the comprehensive treatment of breast cancer (BC), which has an effect on the treatment effectiveness and patients’ quality of life.Objective: To evaluate changes in pulmonary ventilation and diffusion characteristics and ventilation effectiveness in patients with BC before and after radiation therapy (RT).Methods: Our prospective cohort study included 232 women with BC admitted to the Meshalkin National Medical Research Center for an adjuvant RT after surgical treatment. Before and after the RT we conducted pulmonary function tests: body plethysmography, lung diffusion capacity testing, and cardiopulmonary exercise testing with measurement of peak oxygen consumption. We used multivariate regression analysis to determine predictors of pulmonary function decline during RT (decrease in the lung diffusion capacity > 5% compared with baseline).Results: Pulmonary function tests prior to RT demonstrated that 15% of the patients with BC had pulmonary ventilation disorders, and 25% of the patients had pulmonary gas exchange abnormalities (most of them were newly diagnosed). In the general group following RT, we saw a significant decrease in the lung diffusion capacity (P = .044) and an increased incidence of obstructive breathing patterns among the examined patients (P = .036). Other pulmonary ventilation parameters, its effectiveness, and reserve capacity of the respiratory system after RT did not change significantly in the study group and corresponded to the reference values. The postradiation pulmonary function was negatively affected by the reduced level of pulmonary diffusion capacity at baseline (≤ 70% of the reference value) [OR 1.15 (1.03-1.34), P = .004], abnormal breathing pattern prior to RT [OR 1.08 (1.01-1.15), P = .029], involvement of regional lymph nodes (N1-3) [OR 1.10 (1.04-1.26), P = .003].Conclusion: Early postradiation respiratory disorders in patients with BC are marked by a decrease in the lung diffusion capacity and an increased incidence of obstructive patterns of pulmonary ventilation. The factors negatively affecting changes in pulmonary ventilation and diffusion characteristics after RT were the baseline pulmonary gas exchange disorders, obstructive breathing pattern prior to RT, and radiation exposure to lymph nodes.\u0000Received 28 December 2022. Revised 26 May 2023. Accepted 30 May 2023.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: O.V. Kamenskaya, V.V. Lomivorotov Data collection and analysis: S.S. Porotnikova, E.A. Samoilova, V.G. Tihomirov Statistical analysis: I.Yu. Loginova, A.S. Klinkova Drafting the article: I.Yu. Loginova, O.V. Kamenskaya Critical revision of the article: S.E. Krasilnikov, A.M. Chernyavskiy Final approval of the version to be published: O.V. Kamenskaya, I.Yu. Loginova, A.S. Klinkova, S.S. Porotni","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"2015 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87077442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.21688/1681-3472-2023-2-74-86
V. Matveeva, M. Rezvova, T. V. Glushkova, A. V. Sergeeva, E. Krivkina, L. Antonova, L. Barbarash
Background: Interpenetrating polymer network (IPN) hybrid hydrogels enable regulating their properties by varying the composition and concentration of their components. Fibrin is an available natural polymer with ideal biological properties but low strength and tendency to retraction. Polyvinyl alcohol hydrogels are stable, comparable in strength to biological tissues but bioinert. Fibrin/polyvinyl alcohol (F/PVA) IPN can overcome the shortcomings of each component and create an improved material for tissue engineering.Objective: To assess the possibility of and conditions for obtaining a homogeneous IPN by subsequent fibrin polymerization and polyvinyl alcohol cryostructuring while preserving as much as possible mechanical and biological properties beneficial for tissue engineering.Methods: F/PVA IPN was obtained by subsequent fibrin polymerization (30 mg/mL) and polyvinyl alcohol cryostructuring (15, 30, and 60 mg/mL). We studied the structure using a scanning electron microscope, histology, infrared spectroscopy, and X-ray diffraction analysis. We tested mechanical properties and shrinkage of the samples. Biological features were assessed in vitro in terms of viability, cell count, proliferative and metabolic activity of EA.hy926 endothelial cell culture.Results: Our study found the maximum amount of fibrin on the surface of F30PVA15 IPN and its minimum amount on the surface of F30PVA60. These results were supported by the high biological appeal of F30PVA15 compared with F30PVA30 and F30PVA60. F30PVA60 hydrogels demonstrated shrinkage resistance compared to the template; F30PVA30 and F30PVA15 samples decreased by 1.4 and 2.5 times, respectively. Although the mechanical strength of all monocomponent hydrogels and IPN samples did not compare to that of the internal thoracic vein, F30PVA30 and F30PVA60 demonstrated better results than F30PVA15 and fibrin alone.Conclusion: Our method allows obtaining shrink-resistant IPN hydrogels with improved mechanical and tolerable biological properties at polyvinyl alcohol concentrations of > 15 mg/mL and < 60 mg/mL. However, the insufficient strength of this material limits its use in vascular engineering to a modifying coating. Received 25 January 2023. Revised 17 March 2023. Accepted 29 March 2023. Funding: This research was funded by the complex program of basic research under the Siberian Branch of the Russian Academy of Sciences within the basic research topic of Research Institute for Complex Issues of Cardiovascular Diseases No. 0419-2022-0001 “Molecular, cellular and biomechanical mechanisms of the pathogenesis of cardiovascular diseases in the development of new treatment methods based on personalized pharmacotherapy, minimally invasive medical devices, biomaterials and tissue-engineered implants”. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: V.G. Matveeva, M.A. RezvovaData collection and analysis: V.G. Matveeva, M.A. Rezv
背景:互穿聚合物网络(IPN)杂化水凝胶可以通过改变其组分的组成和浓度来调节其性能。纤维蛋白是一种可用的天然聚合物，具有理想的生物学性能，但强度低，易收缩。聚乙烯醇水凝胶稳定，强度与生物组织相当，但具有生物惰性。纤维蛋白/聚乙烯醇(F/PVA) IPN可以克服每种组分的缺点，为组织工程创造一种改进的材料。目的:探讨通过纤维蛋白聚合和聚乙烯醇冷冻处理获得均匀IPN的可能性和条件，同时尽可能保留有利于组织工程的力学和生物学特性。方法:采用纤维蛋白聚合(30 mg/mL)和聚乙烯醇冷冻(15、30、60 mg/mL)法制备F/PVA IPN。我们用扫描电镜、组织学、红外光谱和x射线衍射分析对其结构进行了研究。我们测试了样品的机械性能和收缩率。通过体外培养EA.hy926内皮细胞的活力、细胞计数、增殖和代谢活性等生物学特性进行评价。结果:我们的研究发现F30PVA15 IPN表面的纤维蛋白含量最多，F30PVA60表面的纤维蛋白含量最少。与F30PVA30和F30PVA60相比，F30PVA15具有更高的生物学吸引力，这也支持了这些结果。与模板相比，F30PVA60水凝胶具有抗收缩性;F30PVA30和F30PVA15样品分别下降了1.4倍和2.5倍。虽然所有单组分水凝胶和IPN样品的机械强度与胸内静脉样品的机械强度没有比较，但F30PVA30和F30PVA60的效果优于F30PVA15和单独使用纤维蛋白。结论:我们的方法可以在聚乙烯醇浓度> 15 mg/mL和< 60 mg/mL时获得抗收缩IPN水凝胶，具有改善的机械性能和耐受的生物性能。然而，这种材料的强度不足限制了它在血管工程中的应用。2023年1月25日收到。2023年3月17日修订。2023年3月29日录用。资助:本研究由俄罗斯科学院西伯利亚分院基础研究综合项目资助，该项目隶属于“心血管疾病复杂问题研究所”基础研究课题(0419-2022-0001)“基于个性化药物治疗、微创医疗器械的新治疗方法开发中的心血管疾病发病机制的分子、细胞和生物力学机制”。生物材料和组织工程植入物”。利益冲突:作者声明无利益冲突。作者贡献概念和研究设计:V.G. Matveeva, M.A. Rezvova收集和分析:V.G. Matveeva, M.A. Rezvova, T.V. Glushkova, E.O. Krivkina, A.V. sergeev统计分析:V.G. Matveeva, M.A. Rezvova, T.V. Glushkova, A.V. sergeev文章起草:V.G. Matveeva文章的关键修改:V.G. Matveeva, M.A. Rezvova, L.V. Antonova, L.S. barbarash最终批准发布:V.G. Matveeva, M.A. Rezvova, T.V. Glushkova, A.V. Sergeeva, E.O. Krivkina, L.V. Antonova, L.S. Barbarash
{"title":"Structure and properties of fibrin/polyvinyl alcohol interpenetrating polymer network hydrogel as a modifying coating for small-diameter vascular grafts","authors":"V. Matveeva, M. Rezvova, T. V. Glushkova, A. V. Sergeeva, E. Krivkina, L. Antonova, L. Barbarash","doi":"10.21688/1681-3472-2023-2-74-86","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-2-74-86","url":null,"abstract":"Background: Interpenetrating polymer network (IPN) hybrid hydrogels enable regulating their properties by varying the composition and concentration of their components. Fibrin is an available natural polymer with ideal biological properties but low strength and tendency to retraction. Polyvinyl alcohol hydrogels are stable, comparable in strength to biological tissues but bioinert. Fibrin/polyvinyl alcohol (F/PVA) IPN can overcome the shortcomings of each component and create an improved material for tissue engineering.Objective: To assess the possibility of and conditions for obtaining a homogeneous IPN by subsequent fibrin polymerization and polyvinyl alcohol cryostructuring while preserving as much as possible mechanical and biological properties beneficial for tissue engineering.Methods: F/PVA IPN was obtained by subsequent fibrin polymerization (30 mg/mL) and polyvinyl alcohol cryostructuring (15, 30, and 60 mg/mL). We studied the structure using a scanning electron microscope, histology, infrared spectroscopy, and X-ray diffraction analysis. We tested mechanical properties and shrinkage of the samples. Biological features were assessed in vitro in terms of viability, cell count, proliferative and metabolic activity of EA.hy926 endothelial cell culture.Results: Our study found the maximum amount of fibrin on the surface of F30PVA15 IPN and its minimum amount on the surface of F30PVA60. These results were supported by the high biological appeal of F30PVA15 compared with F30PVA30 and F30PVA60. F30PVA60 hydrogels demonstrated shrinkage resistance compared to the template; F30PVA30 and F30PVA15 samples decreased by 1.4 and 2.5 times, respectively. Although the mechanical strength of all monocomponent hydrogels and IPN samples did not compare to that of the internal thoracic vein, F30PVA30 and F30PVA60 demonstrated better results than F30PVA15 and fibrin alone.Conclusion: Our method allows obtaining shrink-resistant IPN hydrogels with improved mechanical and tolerable biological properties at polyvinyl alcohol concentrations of > 15 mg/mL and < 60 mg/mL. However, the insufficient strength of this material limits its use in vascular engineering to a modifying coating.\u0000Received 25 January 2023. Revised 17 March 2023. Accepted 29 March 2023.\u0000Funding: This research was funded by the complex program of basic research under the Siberian Branch of the Russian Academy of Sciences within the basic research topic of Research Institute for Complex Issues of Cardiovascular Diseases No. 0419-2022-0001 “Molecular, cellular and biomechanical mechanisms of the pathogenesis of cardiovascular diseases in the development of new treatment methods based on personalized pharmacotherapy, minimally invasive medical devices, biomaterials and tissue-engineered implants”.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: V.G. Matveeva, M.A. RezvovaData collection and analysis: V.G. Matveeva, M.A. Rezv","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81937923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.21688/1681-3472-2023-2-42-53
M. Nuzhdin, R. Komarov, D. A. Matsuganov, I. Melnikov, A.V. Tsaregorodtsev
Objective: To summarize and critically appraise the world experience with homografts in mitral and tricuspid valve surgery.Methods: We conducted a systematic review according to the PRISMA criteria. We searched the following terms in available databases, such as PubMed (National Center for Biotechnology Information), Cochrane Library, Web of Science (Clarivate), and Google Scholar: ((mitral homograft) OR (tricuspid homograft) OR (homograft) AND (valve replacement) OR (valve repair)).Results: We recruited 3 specialists to search the information matching our inclusion and exclusion criteria and selected 23 publications covering the period 1988-2021 for analysis. The mean follow-up period was 15 [6-60] months. Survival at the end of the follow-up period was 100% [90.7%-100.0%]; freedom from graft dysfunction was 100%, and freedom from reoperation was 100% [79%-100%].Conclusion: The world experience with homografts in atrioventricular valve surgery is limited to small case series with inconclusive surgical aspects and a heterogeneous follow-up period. The immediate results suggest that homografts could be used as an alternative valve substitute for a wide spectrum of diseases both in primary and revision surgery. Received 19 April 2023. Revised 14 May 2023. Accepted 15 May 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: M.D. Nuzhdin, R.N. KomarovData collection and analysis: M.D. Nuzhdin, D.A. Matsuganov, I.Yu. Melnikov, A.V. TsaregorodtsevStatistical analysis: D.A. MatsuganovDrafting the article: M.D. NuzhdinCritical revision of the article: R.N. Komarov, M.D. NuzhdinFinal approval of the version to be published: M.D. Nuzhdin, R.N. Komarov, D.A. Matsuganov, I.Yu. Melnikov, A.V. Tsaregorodtsev
{"title":"Technical aspects and outcomes of using homografts in atrioventricular valve surgery: a systematic review","authors":"M. Nuzhdin, R. Komarov, D. A. Matsuganov, I. Melnikov, A.V. Tsaregorodtsev","doi":"10.21688/1681-3472-2023-2-42-53","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-2-42-53","url":null,"abstract":"Objective: To summarize and critically appraise the world experience with homografts in mitral and tricuspid valve surgery.Methods: We conducted a systematic review according to the PRISMA criteria. We searched the following terms in available databases, such as PubMed (National Center for Biotechnology Information), Cochrane Library, Web of Science (Clarivate), and Google Scholar: ((mitral homograft) OR (tricuspid homograft) OR (homograft) AND (valve replacement) OR (valve repair)).Results: We recruited 3 specialists to search the information matching our inclusion and exclusion criteria and selected 23 publications covering the period 1988-2021 for analysis. The mean follow-up period was 15 [6-60] months. Survival at the end of the follow-up period was 100% [90.7%-100.0%]; freedom from graft dysfunction was 100%, and freedom from reoperation was 100% [79%-100%].Conclusion: The world experience with homografts in atrioventricular valve surgery is limited to small case series with inconclusive surgical aspects and a heterogeneous follow-up period. The immediate results suggest that homografts could be used as an alternative valve substitute for a wide spectrum of diseases both in primary and revision surgery.\u0000Received 19 April 2023. Revised 14 May 2023. Accepted 15 May 2023.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: M.D. Nuzhdin, R.N. KomarovData collection and analysis: M.D. Nuzhdin, D.A. Matsuganov, I.Yu. Melnikov, A.V. TsaregorodtsevStatistical analysis: D.A. MatsuganovDrafting the article: M.D. NuzhdinCritical revision of the article: R.N. Komarov, M.D. NuzhdinFinal approval of the version to be published: M.D. Nuzhdin, R.N. Komarov, D.A. Matsuganov, I.Yu. Melnikov, A.V. Tsaregorodtsev","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73984598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.21688/1681-3472-2023-2-7-18
K. Pishchulov, M. Simakova, V. Lukinov, S. I. Parkhomenko, N. E. Voinov, S. S. Sklyar, O. Moiseeva
Background: Ranking third in the cause of death structure, venous thromboembolism (VTE) is a frequent complication in patients with central nervous system tumors.Objective: To assess the incidence of venous thrombosis and its risk factors in glioma patients based on retrospective data.Methods: Our retrospective study included 186 glioma patients from the Neurosurgery Department of Almazov National Medical Research Centre.Results: The VTE incidence was 8% in patients with brain neoplasms. Comparative analysis of 2 groups to identify VTE predictors showed that the probability of thrombosis increases with factors leading to the patient immobilization: altered mental status (40% [n = 6] in the VTE group vs 18% [n = 30] in the non-VTE group, OR: 3.1 [95% СI: 0.8–10.6], P = .080), neurological deficit (67% [n = 50] vs 29% [n = 10], OR: 4.8 [95% СI: 1.4–18.7], P = .007), and bed rest for more than 3 days (33% vs 4%, OR: 13.1 [95% СI: 2.7–62.8], P < .001). Based on the validation results, Caprini and IMPROVEDD risk scores have high negative predictive values: 0.99 [95% СI: 0.93–1.00] vs 0.97 [95% СI: 0.93–0.99] (P = .317). Caprini risk score has a specificity of 48.2% and a sensitivity of 93.3% (AUC = 78.98); the threshold value for high-risk VTE detection is 5.5 points. IMPROVEDD risk score has a specificity of 82.5% and a sensitivity of 73.3% (AUC = 81.1); the threshold value for high-risk VTE detection is 4.5 points.Conclusion: Our study revealed VTE risk factors in glioma patients, such as neurological deficit, prolonged bed rest (more than 3 days), and a high-grade tumor. We demonstrated high negative predictive values of Caprini and IMPROVEDD risk scores and determined their threshold values to be validated in a further prospective study. Due to the high incidence of VTE and risks of hemorrhage in patients with central nervous system tumors, personalized venous thrombosis risk calculators should be developed, providing for features of thrombosis pathogenesis in this patient group. Received 12 December 2022. Revised 7 April 2023. Accepted 31 May 2023. Funding: The study was supported by Ministry of Science and Higher Education of Russian Federation (No. 075-15-2022-301). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: K.A. Pishchulov, M.A. SimakovaData collection and analysis: K.A. Pishchulov, S.I. ParkhomenkoStatistical analysis: V.L. LukinovDrafting the article: K.A. Pishchulov, M.A. Simakova, V.L. Lukinov, S.I. Parkhomenko, N.E. Voinov, S.S. Sklyar, O.M. MoiseevaCritical revision of the article: K.A. Pishchulov, M.A. Simakova, V.L. Lukinov, S.I. Parkhomenko, N.E. Voinov, S.S. Sklyar, O.M. MoiseevaFinal approval of the version to be published: K.A. Pishchulov, M.A. Simakova, V.L. Lukinov, S.I. Parkhomenko, N.E. Voinov, S.S. Sklyar, O.M. Moiseeva
{"title":"Risk factors for venous thromboembolism in glioma patients","authors":"K. Pishchulov, M. Simakova, V. Lukinov, S. I. Parkhomenko, N. E. Voinov, S. S. Sklyar, O. Moiseeva","doi":"10.21688/1681-3472-2023-2-7-18","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-2-7-18","url":null,"abstract":"Background: Ranking third in the cause of death structure, venous thromboembolism (VTE) is a frequent complication in patients with central nervous system tumors.Objective: To assess the incidence of venous thrombosis and its risk factors in glioma patients based on retrospective data.Methods: Our retrospective study included 186 glioma patients from the Neurosurgery Department of Almazov National Medical Research Centre.Results: The VTE incidence was 8% in patients with brain neoplasms. Comparative analysis of 2 groups to identify VTE predictors showed that the probability of thrombosis increases with factors leading to the patient immobilization: altered mental status (40% [n = 6] in the VTE group vs 18% [n = 30] in the non-VTE group, OR: 3.1 [95% СI: 0.8–10.6], P = .080), neurological deficit (67% [n = 50] vs 29% [n = 10], OR: 4.8 [95% СI: 1.4–18.7], P = .007), and bed rest for more than 3 days (33% vs 4%, OR: 13.1 [95% СI: 2.7–62.8], P < .001). Based on the validation results, Caprini and IMPROVEDD risk scores have high negative predictive values: 0.99 [95% СI: 0.93–1.00] vs 0.97 [95% СI: 0.93–0.99] (P = .317). Caprini risk score has a specificity of 48.2% and a sensitivity of 93.3% (AUC = 78.98); the threshold value for high-risk VTE detection is 5.5 points. IMPROVEDD risk score has a specificity of 82.5% and a sensitivity of 73.3% (AUC = 81.1); the threshold value for high-risk VTE detection is 4.5 points.Conclusion: Our study revealed VTE risk factors in glioma patients, such as neurological deficit, prolonged bed rest (more than 3 days), and a high-grade tumor. We demonstrated high negative predictive values of Caprini and IMPROVEDD risk scores and determined their threshold values to be validated in a further prospective study. Due to the high incidence of VTE and risks of hemorrhage in patients with central nervous system tumors, personalized venous thrombosis risk calculators should be developed, providing for features of thrombosis pathogenesis in this patient group.\u0000Received 12 December 2022. Revised 7 April 2023. Accepted 31 May 2023.\u0000Funding: The study was supported by Ministry of Science and Higher Education of Russian Federation (No. 075-15-2022-301).\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: K.A. Pishchulov, M.A. SimakovaData collection and analysis: K.A. Pishchulov, S.I. ParkhomenkoStatistical analysis: V.L. LukinovDrafting the article: K.A. Pishchulov, M.A. Simakova, V.L. Lukinov, S.I. Parkhomenko, N.E. Voinov, S.S. Sklyar, O.M. MoiseevaCritical revision of the article: K.A. Pishchulov, M.A. Simakova, V.L. Lukinov, S.I. Parkhomenko, N.E. Voinov, S.S. Sklyar, O.M. MoiseevaFinal approval of the version to be published: K.A. Pishchulov, M.A. Simakova, V.L. Lukinov, S.I. Parkhomenko, N.E. Voinov, S.S. Sklyar, O.M. Moiseeva","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77252210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.21688/1681-3472-2023-2-35-41
К.Н. Куатбеков, Е.А. Енин, А.Л. Егизеков, А.В. Мишин, А.А. Сарсембаева, K. Kuatbekov, Evgenii A. Enin, A. Egizekov, A. Mishin, Anar Sarsembayeva, Orcid K.N. Kuatbekov
Objective: To describe rare clinical and morphological forms of right ventricular neoplasms (mesenchymal hamartoma, rhabdomyoma) in infants which required surgical treatment in infancy.Methods: We performed 2 radical operations to remove right ventricular neoplasms: neonatal mesenchymal hamartoma and infantile rhabdomyoma.Results: We confirmed the effectiveness of surgery for rhabdomyoma and mesenchymal hamartoma in infants based on an 11-year postoperative follow-up period. We followed a necessary search strategy to detect tuberous sclerosis complex often associated with rhabdomyoma.Conclusion: Surgical treatment of rare right ventricular neoplasms in infants demonstrated favorable long-term results. Received 29 December 2022. Revised 22 February 2023. Accepted 27 March 2023. Informed consent: The patients' mothers informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsLiterature review: E.A. Enin, A.V. MishinDrafting the article: A.V. MishinCritical revision of the article: K.N. Kuatbekov, E.A. Enin, A.L. Egizekov, A.A. SarsembayevaSurgical treatment: K.N. Kuatbekov, A.V. MishinFinal approval of the version to be published: K.N. Kuatbekov, E.A. Enin, A.L. Egizekov, A.V. Mishin, A.A. Sarsembayeva
{"title":"Surgical treatment of rare benign right ventricular tumors in infants: two case reports","authors":"К.Н. Куатбеков, Е.А. Енин, А.Л. Егизеков, А.В. Мишин, А.А. Сарсембаева, K. Kuatbekov, Evgenii A. Enin, A. Egizekov, A. Mishin, Anar Sarsembayeva, Orcid K.N. Kuatbekov","doi":"10.21688/1681-3472-2023-2-35-41","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-2-35-41","url":null,"abstract":"Objective: To describe rare clinical and morphological forms of right ventricular neoplasms (mesenchymal hamartoma, rhabdomyoma) in infants which required surgical treatment in infancy.Methods: We performed 2 radical operations to remove right ventricular neoplasms: neonatal mesenchymal hamartoma and infantile rhabdomyoma.Results: We confirmed the effectiveness of surgery for rhabdomyoma and mesenchymal hamartoma in infants based on an 11-year postoperative follow-up period. We followed a necessary search strategy to detect tuberous sclerosis complex often associated with rhabdomyoma.Conclusion: Surgical treatment of rare right ventricular neoplasms in infants demonstrated favorable long-term results.\u0000Received 29 December 2022. Revised 22 February 2023. Accepted 27 March 2023.\u0000Informed consent: The patients' mothers informed consent to use the records for medical purposes is obtained.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsLiterature review: E.A. Enin, A.V. MishinDrafting the article: A.V. MishinCritical revision of the article: K.N. Kuatbekov, E.A. Enin, A.L. Egizekov, A.A. SarsembayevaSurgical treatment: K.N. Kuatbekov, A.V. MishinFinal approval of the version to be published: K.N. Kuatbekov, E.A. Enin, A.L. Egizekov, A.V. Mishin, A.A. Sarsembayeva","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89826330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.21688/1681-3472-2023-1-17-29
A. Vereshchagina, T. Uskach, O. Sapelnikov, V. A. Amanatova, I. Grishin
Objective: To evaluate the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators versus transvenous implantable cardioverter-defibrillators during 6-month follow-up.Methods: The prospective research successively included 95 patients with indications for primary prevention of sudden cardiac death. The patients were divided into 2 groups: group 1 — 52 patients with subcutaneous implantable cardioverter-defibrillators, group 2 — 43 patients with transvenous implantable cardioverter-defibrillators. The patients were followed up for 6 months. All episodes of applied shock therapy, complications, patients changes in the condition and quality of life were analyzed.Results: The groups were initially comparable in terms of gender, age, etiology of the disease, and severity of the condition. Male patients prevailed (subcutaneous implantable cardioverter-defibrillators — 90.3%, transvenous implantable cardioverter-defibrillators — 93.0%), the mean age for subcutaneous devices was 56 [49;62] years and 60 [54;65] years for transvenous implantable cardioverter-defibrillators. All patients had chronic heart failure. The median LV EF for subcutaneous implantable cardioverter-defibrillator and transvenous implantable cardioverter-defibrillator was 29% [26;32] and 30% [27;32], respectively, EDV — 220 mL [187;278] and 202 mL [186;248], ESV — 151 mL [126;188] and 145 mL [122;184]. The number of complications recorded during the 6-month follow-up was slightly higher in patients who were implanted with subcutaneous implantable cardioverter-defibrillator (subcutaneous implantable cardioverter-defibrillators — 7.6%, transvenous implantable cardioverter-defibrillators — 2.3%, p = 0.249). The incidence of inadequate shocks in the groups was comparable (7.7% for subcutaneous implantable cardioverter-defibrillators, 6.9% for transvenous implantable cardioverter-defibrillators, p = 0.882). The percentage of using adequate shock therapy was higher in the transvenous implantable cardioverter-defibrillator group, 18.6% versus 5.7% in the subcutaneous implantable cardioverter-defibrillator group (p = 0.051). Implantation of the devices (both subcutaneous and transvenous) improved quality of life according to the results of questionnaires (Minnesota and EQ-5D questionnaires) before implantation and after 6 months of follow-up (p < 0.001 in both groups).Conclusion: This research demonstrates comparable results for the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators compared with transvenous implantable cardioverter-defibrillators in patients with the need for primary prevention of sudden cardiac death within 6 months. Received 6 October 2022. Revised 28 February 2023. Accepted 1 March 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: A.V. Vereshchagina, T.M. Uskach, O.V. SapelnikovData collection and
{"title":"Subcutaneous versus transvenous cardioverter-defibrillators: 6-month follow-up","authors":"A. Vereshchagina, T. Uskach, O. Sapelnikov, V. A. Amanatova, I. Grishin","doi":"10.21688/1681-3472-2023-1-17-29","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-17-29","url":null,"abstract":"Objective: To evaluate the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators versus transvenous implantable cardioverter-defibrillators during 6-month follow-up.Methods: The prospective research successively included 95 patients with indications for primary prevention of sudden cardiac death. The patients were divided into 2 groups: group 1 — 52 patients with subcutaneous implantable cardioverter-defibrillators, group 2 — 43 patients with transvenous implantable cardioverter-defibrillators. The patients were followed up for 6 months. All episodes of applied shock therapy, complications, patients changes in the condition and quality of life were analyzed.Results: The groups were initially comparable in terms of gender, age, etiology of the disease, and severity of the condition. Male patients prevailed (subcutaneous implantable cardioverter-defibrillators — 90.3%, transvenous implantable cardioverter-defibrillators — 93.0%), the mean age for subcutaneous devices was 56 [49;62] years and 60 [54;65] years for transvenous implantable cardioverter-defibrillators. All patients had chronic heart failure. The median LV EF for subcutaneous implantable cardioverter-defibrillator and transvenous implantable cardioverter-defibrillator was 29% [26;32] and 30% [27;32], respectively, EDV — 220 mL [187;278] and 202 mL [186;248], ESV — 151 mL [126;188] and 145 mL [122;184]. The number of complications recorded during the 6-month follow-up was slightly higher in patients who were implanted with subcutaneous implantable cardioverter-defibrillator (subcutaneous implantable cardioverter-defibrillators — 7.6%, transvenous implantable cardioverter-defibrillators — 2.3%, p = 0.249). The incidence of inadequate shocks in the groups was comparable (7.7% for subcutaneous implantable cardioverter-defibrillators, 6.9% for transvenous implantable cardioverter-defibrillators, p = 0.882). The percentage of using adequate shock therapy was higher in the transvenous implantable cardioverter-defibrillator group, 18.6% versus 5.7% in the subcutaneous implantable cardioverter-defibrillator group (p = 0.051). Implantation of the devices (both subcutaneous and transvenous) improved quality of life according to the results of questionnaires (Minnesota and EQ-5D questionnaires) before implantation and after 6 months of follow-up (p < 0.001 in both groups).Conclusion: This research demonstrates comparable results for the effectiveness and safety of subcutaneous implantable cardioverter-defibrillators compared with transvenous implantable cardioverter-defibrillators in patients with the need for primary prevention of sudden cardiac death within 6 months.\u0000Received 6 October 2022. Revised 28 February 2023. Accepted 1 March 2023.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: A.V. Vereshchagina, T.M. Uskach, O.V. SapelnikovData collection and","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87005333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.21688/1681-3472-2023-1-47-53
D. Losik, V. Beloborodov, E. Fisher, V. Murtazin, A. Filippenko, I. Mikheenko, V. Shabanov, A. Romanov
Objective: To evaluate the model of atrial fibrillation (AF) in mini-pigs with endocardial approach implantation of CRT-P using bi-electrodes pacing through RV/LV connectors.Methods: All surgical interventions were minimally invasive and conducted under general anaesthesia. CRT-P was implanted endocardially, using X-ray. First electrode was fixed in the right atrial appendage. The second one — in the interatrial septum or the right atrial free wall. Both of them were connected with CRT-P through RV/LV. Bi-electrode atrial stimulation was realized during a week with a basic heart rate of 150 bpm and a delay between electrodes of 80 ms (mean 450 bpm), which corresponds to the heart rate (HR) of AF. Electrophysiological study was performed during the experiment to analyze the cardiac conduction system. AF inducibility was evaluated before and after stimulation.Results: A series of experiments demonstrated that there were no complications following the device and electrodes implantation. There was a non-sustained paroxysm of AF before permanent pacing in one of three pigs. After pacing we noted a tendency to increase the baseline HR (average frequency from 94 ± 4 to 98 ± 6 bpm). Non-sustained paroxysm of AF was induced in all cases. The sustained AF with 92 min burden was induced in one pig.Conclusion: Endocardial bi-electrode atrial pacing in mini-pigs has proven to be safe. This AF model improves AF inducibility and can be considered as an alternative to epicardial stimulation for experiments employing AF models. Received 4 December 2022. Revised 17 January 2023. Accepted 18 January 2023. Funding: The study was supported by Russian Science Foundation (project No. 22-25-00672). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: V.V. Beloborodov, D.V. Losik, E.V. FisherData collection and analysis: E.V. Fisher, V.V. Beloborodov, D.V. Losik, A.G. FilippenkoDrafting the article: D.V. Losik, E.V. Fisher, V.I. Murtazin, V.V. BeloborodovCritical revision of the article: A.B. Romanov, D.V. Losik, V.V. Shabanov, I.L. MikheenkoFinal approval of the version to be published: D.V. Losik, V.V. Beloborodov, E.V. Fisher, V.I. Murtazin, A.G. Filippenko, I.L. Mikheenko, V.V. Shabanov, A.B. Romanov
{"title":"New atrial fibrillation model with endocardial approach by CRT bi-electrode atrial pacing in mini-pigs","authors":"D. Losik, V. Beloborodov, E. Fisher, V. Murtazin, A. Filippenko, I. Mikheenko, V. Shabanov, A. Romanov","doi":"10.21688/1681-3472-2023-1-47-53","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-47-53","url":null,"abstract":"Objective: To evaluate the model of atrial fibrillation (AF) in mini-pigs with endocardial approach implantation of CRT-P using bi-electrodes pacing through RV/LV connectors.Methods: All surgical interventions were minimally invasive and conducted under general anaesthesia. CRT-P was implanted endocardially, using X-ray. First electrode was fixed in the right atrial appendage. The second one — in the interatrial septum or the right atrial free wall. Both of them were connected with CRT-P through RV/LV. Bi-electrode atrial stimulation was realized during a week with a basic heart rate of 150 bpm and a delay between electrodes of 80 ms (mean 450 bpm), which corresponds to the heart rate (HR) of AF. Electrophysiological study was performed during the experiment to analyze the cardiac conduction system. AF inducibility was evaluated before and after stimulation.Results: A series of experiments demonstrated that there were no complications following the device and electrodes implantation. There was a non-sustained paroxysm of AF before permanent pacing in one of three pigs. After pacing we noted a tendency to increase the baseline HR (average frequency from 94 ± 4 to 98 ± 6 bpm). Non-sustained paroxysm of AF was induced in all cases. The sustained AF with 92 min burden was induced in one pig.Conclusion: Endocardial bi-electrode atrial pacing in mini-pigs has proven to be safe. This AF model improves AF inducibility and can be considered as an alternative to epicardial stimulation for experiments employing AF models.\u0000Received 4 December 2022. Revised 17 January 2023. Accepted 18 January 2023.\u0000Funding: The study was supported by Russian Science Foundation (project No. 22-25-00672).\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: V.V. Beloborodov, D.V. Losik, E.V. FisherData collection and analysis: E.V. Fisher, V.V. Beloborodov, D.V. Losik, A.G. FilippenkoDrafting the article: D.V. Losik, E.V. Fisher, V.I. Murtazin, V.V. BeloborodovCritical revision of the article: A.B. Romanov, D.V. Losik, V.V. Shabanov, I.L. MikheenkoFinal approval of the version to be published: D.V. Losik, V.V. Beloborodov, E.V. Fisher, V.I. Murtazin, A.G. Filippenko, I.L. Mikheenko, V.V. Shabanov, A.B. Romanov","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77947553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.21688/1681-3472-2023-1-60-66
V. Podzolkov, A. Minaev, M. Chiaureli, V. Cheban, E. Golubev, K. Petrosyan, A. Sobolev, I. Zemlyanskaya
Background: The relevance of coronary artery disease treatment in congenital heart disease is related to the increasing number of older patients with congenital conditions, predisposing factors and continuous silent ischemia.Objective: To analyze clinical data and results of surgery in patients with a combination of congenital heart disease and hemodynamically significant coronary artery lesions.Methods: 17 patients (7 women (41.2%), 10 men (58.8%)) were included in the study. All of them underwent myocardial revascularization and congenital heart disease corrective surgery from 2003 to 2020. The mean age at the time of surgery was 57.2 years. The congenital diagnosis was an atrial septal defect (14 patients), partial anomalous pulmonary vein connection (1 patient), recanalization of atrial septal defect (1 patient), recanalization of ventricular septal defect (1 patient). In 7 cases congenital and coronary pathology correction were performed percutaneously — coronary stenting as the first stage, defect closure at an interval of 4 to 10 days as the second. One patient underwent stenting 7 months prior to an open-heart surgery. In 9 cases one-staged open-heart surgery was performed simultaneously. Results: At the hospital 1 patient died after surgery due to multiple organ dysfunction syndrome. In all other cases there were no symptoms of ischemia on discharge, the patients were in NYHA class I–II (New York Heart Association).Conclusion: The tactics of coronary revascularization is determined by the necessity of percutaneous or open-heart intervention. Myocardial revascularization may be preferable as the first stage, or a one-stage correction may be performed and proved by good results. Received 14 October 2022. Revised 25 November 2022. Accepted 27 November 2022. Informed consent: The patient’s informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsLiterature review: A.V. MinaevDrafting the article: A.V. Minaev, A.V. Sobolev, I.V. ZemlyanskayaCritical revision of the article: V.P. PodzolkovSurgical treatment: M.R. Chiaureli, V.N. Cheban, E.P. Golubev, K.V. PetrosyanFinal approval of the version to be published: V.P. Podzolkov, A.V. Minaev, M.R. Chiaureli, V.N. Cheban, E.P. Golubev, K.V. Petrosyan, A.V. Sobolev, I.V. Zemlyanskaya
{"title":"Coronary artery and congenital heart diseases in adult patients: a case series","authors":"V. Podzolkov, A. Minaev, M. Chiaureli, V. Cheban, E. Golubev, K. Petrosyan, A. Sobolev, I. Zemlyanskaya","doi":"10.21688/1681-3472-2023-1-60-66","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-60-66","url":null,"abstract":"Background: The relevance of coronary artery disease treatment in congenital heart disease is related to the increasing number of older patients with congenital conditions, predisposing factors and continuous silent ischemia.Objective: To analyze clinical data and results of surgery in patients with a combination of congenital heart disease and hemodynamically significant coronary artery lesions.Methods: 17 patients (7 women (41.2%), 10 men (58.8%)) were included in the study. All of them underwent myocardial revascularization and congenital heart disease corrective surgery from 2003 to 2020. The mean age at the time of surgery was 57.2 years. The congenital diagnosis was an atrial septal defect (14 patients), partial anomalous pulmonary vein connection (1 patient), recanalization of atrial septal defect (1 patient), recanalization of ventricular septal defect (1 patient). In 7 cases congenital and coronary pathology correction were performed percutaneously — coronary stenting as the first stage, defect closure at an interval of 4 to 10 days as the second. One patient underwent stenting 7 months prior to an open-heart surgery. In 9 cases one-staged open-heart surgery was performed simultaneously. Results: At the hospital 1 patient died after surgery due to multiple organ dysfunction syndrome. In all other cases there were no symptoms of ischemia on discharge, the patients were in NYHA class I–II (New York Heart Association).Conclusion: The tactics of coronary revascularization is determined by the necessity of percutaneous or open-heart intervention. Myocardial revascularization may be preferable as the first stage, or a one-stage correction may be performed and proved by good results.\u0000Received 14 October 2022. Revised 25 November 2022. Accepted 27 November 2022.\u0000Informed consent: The patient’s informed consent to use the records for medical purposes is obtained.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsLiterature review: A.V. MinaevDrafting the article: A.V. Minaev, A.V. Sobolev, I.V. ZemlyanskayaCritical revision of the article: V.P. PodzolkovSurgical treatment: M.R. Chiaureli, V.N. Cheban, E.P. Golubev, K.V. PetrosyanFinal approval of the version to be published: V.P. Podzolkov, A.V. Minaev, M.R. Chiaureli, V.N. Cheban, E.P. Golubev, K.V. Petrosyan, A.V. Sobolev, I.V. Zemlyanskaya","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88338411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.21688/1681-3472-2023-1-38-46
A. A. Shadanov, I. Zhuravleva, L. Samoylova, T. Timchenko, S. V. Vladimirov, E. V. Karpova, N.E. Luchnikov, D. Sirota, A. Edemskiy, A. Bogachev-Prokofiev, A. Chernyavskiy
Background: Vascular graft infection is a severe cardiovascular complication with high mortality rates. Antibacterial vascular graft coatings are widely used and continue to be improved.Objective: To develop a sealant with antimicrobial effect for Dacron vascular grafts and experimentally test the coating properties.Methods: We used 2 types of vascular grafts: graft No. 1 (plain weave) with initial water permeability of 78.8 ± 2.7 mL/cm2/min and graft No. 2 (2/1 twill + 6/4 satin weave) with water permeability of 549.8 ± 20.7 mL/cm2/min. We developed an original gelatin impregnation technique, tested it using a scanning electron microscopy, and measured water permeability and kink radius. We evaluated the antibacterial activity of vancomycin and gelatin impregnation by the disk diffusion test using media with Staphylococcus aureus ATCC 29213 and Enterococcus faecalis ATCC 29212 and measured inhibition zones after 24-hour incubation. We used samples cut out of grafts with vancomycin-containing (experimental group) and no vancomycin-containing (control group) impregnation.Results: The gelatin coating of the samples is visualized as a thin even film and provides zero water permeability. On the negative side, it increased stiffness and the kink radius. Thanks to vancomycin added to the coating, bacterial growth significantly inhibits: the mean diameter of the growth inhibition zone for Staphylococcus aureus and Enterococcus faecalis was 15.60 ± 0.65 and 14.40 ± 0.66 mm, respectively. The grafts untreated with vancomycin showed no growth inhibition zones.Conclusion: Vascular graft treatment with gelatin impregnation and vancomycin solution is a simple measure to prevent the growth of gram-positive bacteria on vascular grafts. Received 14 November 2022. Revised 15 December 2022. Accepted 19 December 2022. Funding: The work was supported by Russian Science Foundation (project No. 22-15-20005). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: I.Yu. Zhuravleva, A.A. Shadanov, D.A. SirotaData collection and analysis: A.A. Shadanov, L.M. Samoylova, S.V. Vladimirov, T.P. Timchenko, N.E. Luchnikov, E.V. KarpovaStatistical analysis: A.A. ShadanovDrafting the article: A.A. Shadanov, L.M. Samoylova, T.P. Timchenko, A.G. EdemskiyCritical revision of the article: D.A. Sirota, I.Yu. Zhuravleva, A.V. Bogachev-Prokofiev, A.M. ChernyavskiyFinal approval of the version to be published: A.A. Shadanov, I.Yu. Zhuravleva, L.M. Samoylova, T.P. Timchenko, S.V. Vladimirov, E.V. Karpova, N.E. Luchnikov, D.A. Sirota, A.G. Edemskiy, A.V. Bogachev-Prokofiev, A.M. Chernyavskiy
{"title":"Evaluation of the original sealant with antibacterial effect for synthetic vascular grafts","authors":"A. A. Shadanov, I. Zhuravleva, L. Samoylova, T. Timchenko, S. V. Vladimirov, E. V. Karpova, N.E. Luchnikov, D. Sirota, A. Edemskiy, A. Bogachev-Prokofiev, A. Chernyavskiy","doi":"10.21688/1681-3472-2023-1-38-46","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-38-46","url":null,"abstract":"Background: Vascular graft infection is a severe cardiovascular complication with high mortality rates. Antibacterial vascular graft coatings are widely used and continue to be improved.Objective: To develop a sealant with antimicrobial effect for Dacron vascular grafts and experimentally test the coating properties.Methods: We used 2 types of vascular grafts: graft No. 1 (plain weave) with initial water permeability of 78.8 ± 2.7 mL/cm2/min and graft No. 2 (2/1 twill + 6/4 satin weave) with water permeability of 549.8 ± 20.7 mL/cm2/min. We developed an original gelatin impregnation technique, tested it using a scanning electron microscopy, and measured water permeability and kink radius. We evaluated the antibacterial activity of vancomycin and gelatin impregnation by the disk diffusion test using media with Staphylococcus aureus ATCC 29213 and Enterococcus faecalis ATCC 29212 and measured inhibition zones after 24-hour incubation. We used samples cut out of grafts with vancomycin-containing (experimental group) and no vancomycin-containing (control group) impregnation.Results: The gelatin coating of the samples is visualized as a thin even film and provides zero water permeability. On the negative side, it increased stiffness and the kink radius. Thanks to vancomycin added to the coating, bacterial growth significantly inhibits: the mean diameter of the growth inhibition zone for Staphylococcus aureus and Enterococcus faecalis was 15.60 ± 0.65 and 14.40 ± 0.66 mm, respectively. The grafts untreated with vancomycin showed no growth inhibition zones.Conclusion: Vascular graft treatment with gelatin impregnation and vancomycin solution is a simple measure to prevent the growth of gram-positive bacteria on vascular grafts.\u0000Received 14 November 2022. Revised 15 December 2022. Accepted 19 December 2022.\u0000Funding: The work was supported by Russian Science Foundation (project No. 22-15-20005).\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: I.Yu. Zhuravleva, A.A. Shadanov, D.A. SirotaData collection and analysis: A.A. Shadanov, L.M. Samoylova, S.V. Vladimirov, T.P. Timchenko, N.E. Luchnikov, E.V. KarpovaStatistical analysis: A.A. ShadanovDrafting the article: A.A. Shadanov, L.M. Samoylova, T.P. Timchenko, A.G. EdemskiyCritical revision of the article: D.A. Sirota, I.Yu. Zhuravleva, A.V. Bogachev-Prokofiev, A.M. ChernyavskiyFinal approval of the version to be published: A.A. Shadanov, I.Yu. Zhuravleva, L.M. Samoylova, T.P. Timchenko, S.V. Vladimirov, E.V. Karpova, N.E. Luchnikov, D.A. Sirota, A.G. Edemskiy, A.V. Bogachev-Prokofiev, A.M. Chernyavskiy","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87781406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-30DOI: 10.21688/1681-3472-2023-1-7-16
A. Bogachev-Prokophiev, R. Sharifulin, S. Zheleznev, A. Karadzha, A. Afanasyev, A. Pivkin, A. Zalesov
Background: Prosthetic valve endocarditis, the most severe form of infective endocarditis, occurs in 1-6% of patients with valve prostheses and is still associated with poor prognosis and high in-hospital mortality.Objective: To assess outcomes of allograft aortic root replacement in patients with prosthetic valve endocarditis.Methods: The retrospective analysis included adult patients with prosthetic valve endocarditis, who underwent allograft aortic root replacement between 2011 and 2022.Results: Of 15 study patients, early infective endocarditis was found in 60.0% of the cases. The most common cause was Staphylococcus aureus (26.7%). Early mortality was 13.3%. Thromboembolic events occurred in 2 patients (13.3%). The median follow-up period was 48.5 (6-140) months. Late death was reported in 1 patient. The 5-year survival rate was 79.0%. One patient had recurrent infective endocarditis. Two patients underwent reintervention: one for a proximal anastomotic pseudoaneurysm and another one for structural degeneration of the allograft. Five-year freedom from reintervention was 91.7%.Conclusion: Due to the high rate of the freedom from recurrent infective endocarditis, allograft aortic root replacement is an effective treatment for patients with prosthetic valve endocarditis. Received 7 November 2022. Revised 9 December 2022. Accepted 20 December 2022. Funding: The study was supported by the grant of the president of the Russian Federation (No. 075-15-2022-823). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: A.V. Bogachev-ProkophievData collection and analysis: A.V. Karadzha, A.N. Pivkin, A.S. ZalesovStatistical analysis: R.M. Sharifulin, A.V. AfanasyevDrafting the article: R.M. Sharifulin, A.V. AfanasyevCritical revision of the article: A.V. Bogachev-Prokophiev, S.I. ZheleznevFinal approval of the version to be published: A.V. Bogachev-Prokophiev, R.M. Sharifulin, S.I. Zheleznev, A.V. Karadzha, A.V. Afanasyev, A.N. Pivkin, A.S. Zalesov
{"title":"Aortic allografts for surgical treatment of prosthetic valve endocarditis","authors":"A. Bogachev-Prokophiev, R. Sharifulin, S. Zheleznev, A. Karadzha, A. Afanasyev, A. Pivkin, A. Zalesov","doi":"10.21688/1681-3472-2023-1-7-16","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-7-16","url":null,"abstract":"Background: Prosthetic valve endocarditis, the most severe form of infective endocarditis, occurs in 1-6% of patients with valve prostheses and is still associated with poor prognosis and high in-hospital mortality.Objective: To assess outcomes of allograft aortic root replacement in patients with prosthetic valve endocarditis.Methods: The retrospective analysis included adult patients with prosthetic valve endocarditis, who underwent allograft aortic root replacement between 2011 and 2022.Results: Of 15 study patients, early infective endocarditis was found in 60.0% of the cases. The most common cause was Staphylococcus aureus (26.7%). Early mortality was 13.3%. Thromboembolic events occurred in 2 patients (13.3%). The median follow-up period was 48.5 (6-140) months. Late death was reported in 1 patient. The 5-year survival rate was 79.0%. One patient had recurrent infective endocarditis. Two patients underwent reintervention: one for a proximal anastomotic pseudoaneurysm and another one for structural degeneration of the allograft. Five-year freedom from reintervention was 91.7%.Conclusion: Due to the high rate of the freedom from recurrent infective endocarditis, allograft aortic root replacement is an effective treatment for patients with prosthetic valve endocarditis.\u0000Received 7 November 2022. Revised 9 December 2022. Accepted 20 December 2022.\u0000Funding: The study was supported by the grant of the president of the Russian Federation (No. 075-15-2022-823).\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: A.V. Bogachev-ProkophievData collection and analysis: A.V. Karadzha, A.N. Pivkin, A.S. ZalesovStatistical analysis: R.M. Sharifulin, A.V. AfanasyevDrafting the article: R.M. Sharifulin, A.V. AfanasyevCritical revision of the article: A.V. Bogachev-Prokophiev, S.I. ZheleznevFinal approval of the version to be published: A.V. Bogachev-Prokophiev, R.M. Sharifulin, S.I. Zheleznev, A.V. Karadzha, A.V. Afanasyev, A.N. Pivkin, A.S. Zalesov","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81500830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：