Patologiya krovoobrashcheniya i kardiokhirurgiya最新文献

{"title":"Video-assisted thoracoscopic redo sternotomy for primary dysfunction of the aortic root homograft: a case report","authors":"E. Malyshenko, S. Petko, V. Popov, M.G. Gasangusenov, A. Revishvili","doi":"10.21688/1681-3472-2022-3-91-96","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-3-91-96","url":null,"abstract":"Adhesion in the anterior mediastinum following previous heart surgeries is a predictor of fatal trauma of the heart chambers, large vessels and lungs during redo cardiac procedures. The approaches used to prevent such complications have evolved over the past decades, but the need for their improvement remains. Annual increase in heart surgeries, coupled with the phenomenon of “aging population” in economically developed countries, predetermines the growth of redo cardiac surgical procedures. An important role in this process is also played by the recent more active use of various biological implants (for example, bioprosthetic heart valves), which makes the search for new technologies for safe redo sternotomy even more urgent.The publication presents a case of redo surgery in a patient with primary degeneration of the homograft in the aortic root position implanted 13 years ago for aortic stenosis using the Full Root technique. The original technique applied (Method for endoscopic prevention of traumatisation of cardiac, lung and major vessels of anterior mediastenum accompanying repeated cardiosurgical operations. Patent No. RU 2726605 C1) provides for a combination of minimally invasive and classic surgical approaches. Total adhesiolysis of the anterior mediastinum was performed thoracoscopically: the posterior surface of the sternum and the cartilaginous part of the ribs were completely freed from adhesions with the right ventricle, the aorta, lungs and innominate vein. The redo sternotomy was made using a standard electric saw under direct visual control and protection of the right ventricle and the ascending aorta with endoscopic retractors. The risk of surgical trauma of the anterior mediastinum organs was fully eliminated and the intraoperative blood loss was comparable to a traditional sternotomy approach.\u0000Received 27 January 2022. Revised 23 April 2022. Accepted 20 May 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: Authors declare no conflict of interest.\u0000Contribution of the authorsLiterature review: S.A. Petko, V.A. Popov, E.S. MalyshenkoDrafting the article: E.S. Malyshenko, S.A. PetkoCritical revision of the article: E.S. Malyshenko, V.A. Popov, A.Sh. RevishviliSurgical treatment: E.S. Malyshenko, M.G. Gasangusenov, V.A. PopovFinal approval of the version to be published: E.S. Malyshenko, S.A. Petko, V.A. Popov, M.G. Gasangusenov, A.Sh. Revishvili","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83642300","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}

{"title":"The laparoscopic isolation of a splenic artery aneurysm: a case report","authors":"N. S. Odintsov, Yu. K. Belova, A. Vanyurkin, Y. Kudaev, A. Neimark, M. Chernyavskiy","doi":"10.21688/1681-3472-2022-3-97-102","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-3-97-102","url":null,"abstract":"Splenic artery aneurysm is a rather rare abnormality, and its treatment is a pressing issue due to high morbidity and mortality in case of its rupture.Our aim is to show the advantages of the laparoscopy for splenic artery aneurysms.Patient P., 81 years old, was admitted for surgical treatment of the splenic artery aneurysm. Angiography revealed the tortuosity of the splenic artery with a 28-mm distal aneurysm. Laparoscopic treatment of the aneurysm was performed using a stapler. No complications were observed during the postoperative period, so the patient was discharged on day 5.The laparoscopic treatment is a method of choice in patients with a tortuos splenic artery and a distal aneurysm to spare a spleen.\u0000Received 20 December 2021. Revised 13 April 2022. Accepted 26 April 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: Authors declare no conflict of interest.\u0000Contribution of the authorsLiterature review: A.G. Vanyurkin, Yu.A. KudaevDrafting the article: N.S. Odintsov, Yu.K. BelovaCritical revision of the article: A.E. Neimark, M.A. ChernyavskiySurgical treatment: A.E. NeimarkFinal approval of the version to be published: N.S. Odintsov, Yu.K. Belova, A.G. Vanyurkin, Yu.A. Kudaev, A.E. Neimark, M.A. Chernyavskiy","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75207200","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}

{"title":"Study of cardiotoxicity in patients with oncological pathology during chemotherapy","authors":"S. P. Melekhov, E. A. Gromashova, A. S. Tertyuk, A. S. Mansurova, S. Krasilnikov","doi":"10.21688/1681-3472-2022-2-90","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-90","url":null,"abstract":"Background. Cardiological complications occur in 20% of all patients receiving chemotherapy for oncological diseases (the most severe are cardiac rhythm and conduction disturbances, myocardial ischemia and the development of heart failure), which complicates further high-quality antitumor therapy. In addition, 44% of all cancer patients have concomitant cardiovascular pathology, more often coronary artery disease and essential hypertension are detected. Carrying out cardiotoxic chemotherapy in this group of patients worsens the prognosis of concomitant disease.Aim. Conduct a retrospective analysis of 237 patients undergoing antitumor therapy at different stages of treatment. The analysis included those patients who received drugs with a mechanism of myocardial damage according to type 1 cardiotoxicity — doxorubicin, cyclophosphamide, Herceptin.Methods. Review of case histories of 237 patients treated in 2021 with doxorubicin (146 patients), cyclophosphamide (86 patients), Herceptin (5 patients).Results. The use of chemotherapy with the drugs listed above causes irreversible myocardial dysfunction due to the death of cardiomyocytes with the development of left ventricular dysfunction and heart failure, and also worsens the course of concomitant cardiovascular  pathology in patients. For more detailed data, further research is needed, which is continuously ongoing.Conclusion. To date, the fact of the negative impact of chemotherapy on the cardiovascular system is indisputable, however, detailed studies are required. At Meshalkin National Medical Research Center, it is planned to conduct an electrocardiography, an echocardiography with an assessment of the ejection fraction, a general longitudinal strain of the left ventricle myocardium and left ventricle diastolic dysfunction, laboratory tests (troponin T and I, B-type Natriuretic Peptide (BNP), NT-proBNP) and also a comparison of these data with perfusion tomoscintigraphy of the myocardium of each patient undergoing chemotherapy treatment to identify early criteria for the development of cardiotoxicity after each cycle and at the end of chemotherapy, taking into account the total doses of drugs to obtain more accurate and up-to-date data.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77722610","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}

{"title":"Clinical observation of endovascular thoracic aortic prosthetics in a patient with distal anastomosis aneurysm of a vascular prosthesis formed \"end-to-side\" after extraanatomic prosthetics","authors":"N. Gorshkov, N. Chernaya, M. V. Parhomenko, R. Muslimov, V. S. Selyaev, L. Kokov","doi":"10.21688/1681-3472-2022-2-79-84","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-79-84","url":null,"abstract":"A clinical observation of successful prosthetics of an aneurysm of distal anastomosis of a vascular prosthesis of the thoracic aorta with a stent graft in a patient 24 years after extraanatomic bypass surgery with an end-to-side anastomosis for aortic coarctation is presented. During a routine examination, an aneurysm of the distal anastomosis of the vascular prosthesis was revealed in the patient. After further examination, thoracic aorta endoprosthesis was performed from vascular prosthesis to native aorta with Ankura 2020B120 stent graft (Lifetech Scientific Co., LTD. Shenzhen, China). Intraoperative results of endoprosthetics were assessed as good. The aneurysm of the distal anastomosis was not contrasted, the patency of the vessels of the aortic arch was preserved. According to the control computed tomography study performed 3 months after the operation, the aneurysm of the distal anastomosis is not contrasted, there is no dislocation of the prosthesis, there are no endolics. The above clinical observation demonstrates the effectiveness and safety of thoracic aortic endoprosthesis from a vascular prosthesis to a native aorta with anastomosis aneurysms of a vascular prosthesis, which allows avoiding complex and traumatic repeated open surgical intervention on the aorta and achieving good immediate and long-term treatment results.Received 25 November 2021. Revised 29 December 2021. Accepted 31 January 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: Authors declare no conflict of interest.Contribution of the authors Literature review: N.S. Gorshkov. Drafting the article: N.S. Gorshkov, N.R. ChernayaCritical revision of the article: R.Sh. Muslimov, L.S. KokovSurgical treatment: N.S. Gorshkov, N.R. Chernaya, M.V. Parhomenko, V.S. SelyaevFinal approval of the version to be published: N.S. Gorshkov, N.R. Chernaya, M.V. Parhomenko, V.S. Selyaev, L.S. Kokov","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83978614","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}

{"title":"Function of oculumotor, trochlear and abducens nerves in patients with cerebral aneurysms undergoing endovascular treatment","authors":"P. Semin, L. Kirillov, R. Kiselev","doi":"10.21688/1681-3472-2022-2-92","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-92","url":null,"abstract":"Background. Functional impairment of nerves, which move an eyelid, is a serious problem in patients with aneurysms, especially concerning enlarging number of endovascular procedures on cerebral aneurysms.Aim. To evaluate frequency of malfunction of oculomotor, trochlear, abducens nerves in patients with cerebral aneurysms.Methods. From 2019 to 2021 189 patients with 202 aneurysms underwent endovascular treatment. Location of the aneurysms: cavernous, clinoid and communicating segments of the internal carotid arteries, superior cerebellar arteries, P1 and P2 segments of the posterior cerebral arteries. Patients did not have dislocation syndrome as a result of a stroke. There were 37 male patients and 152 female patients. The age of patients ranged from 17 to 78 years, the mean age was 52±12 years. Distribution of aneurysm location: 42 (21%) – cavernous segment of the internal cerebral artery, 25 (12%) – clinoid segment, 110 (55%) – communicating segment, 18 (9%) – superior cerebellar arteries, 7 (3%) – P1 and P2 segments of the posterior cerebral arteries. Morphologically 11 (5%) of the aneurysms were fusiform, 191 (95%) of the aneurysms were saccular. 43 aneurysms (21%) were embolized with coils, 49 (24%) were treated using assisted coiling (balloon- and/or stent-assistance), 83 (42%) of the aneurysms were treated with flow-diverters. 27 (13%) patients underwent several endovascular procedures, including a combination of aforementioned techniques. Function of oculomotor, trochlear and abducens nerves was evaluated at the admission, during the hospitalization and at the discharge. Follow-up was achieved in 102 (54%) patients with 115 aneurysms, the mean follow-up period in June 2022 is 13 months. Checking cerebral angiography was performed 8months after the operation on the average.Results. In 89 (77%) patients checking cerebral angiography showed complete obliteration of the aneurysms, in 26 (23%) filling part of the aneurysm was found out to be smaller. 11 patients had preoperative oculomotor nerve paresis, after the procedure 1 patient had no oculomotor nerve impairment and made a complete recovery, 2 patients had partial improvement, 7 patients had no changes, in 1 patient paresis worsened. In our group we did not observe any case of trochlear nerve palsy either prior or after the operation during follow-up. 6 patients had preoperative abducens nerve paresis, after the treatment 1 patients had a complete recovery of abducens nerve function, 3 patients had partial improvement, 2 patients had no changes.Conclusion. In patients with cerebral aneurysms without cerebral dislocation as result of a stroke function of trochlear nerve did not suffer either prior or after endovascular treatment. Endovascular treatment in this category of patients may positively affect the oculomotor and abducens nerve impairment, but in rare cases it can lead to deterioration of neurological deficit.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84248441","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}

{"title":"Clinical trials of myocardium injury cell therapy","authors":"A. Popandopulo, M. Solopov, V. V. Turchyn, V. Bushe","doi":"10.21688/1681-3472-2022-2-17-29","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-17-29","url":null,"abstract":"The high mortality rate from heart disease requires the development of new therapeutic approaches. Traditional treatments can provide a compensatory effect, improve the patient's quality of life, but not eliminate myocardial loss. Preclinical studies indicate that the regeneration of cardiac tissue can be stimulated through transplantation of stem and progenitor cells.The review describes clinical trials of myocardial injury therapy using regional stem cells, progenitor cells, and cells differentiated from ESC/iPSCs. The results of clinical studies have confirmed the safety and availability of cell therapy for myocardial injury. However, insufficient knowledge of the mechanisms of action of transplanted cells on the myocardium and the rapid deployment of clinical trials initiated by the success of preclinical trials made it possible to observe, at best, only a moderate therapeutic effect. In studies using regional stem cells, it was not possible to reliably confirm their ability to differentiate into cardiomyocytes and integrate into the myocardium, and the observed improvements in heart function are associated with paracrine signaling. Cardiac ESC/iPSC derivatives are more suitable for the restoration of the lost myocardium, but since the number of clinical trials with these types of cells is still small, additional studies are required to confirm their safety and efficacy.When developing the design of future clinical trials of cell therapy, it is necessary to strictly take into account the mechanism of cell action, the pathophysiology of the disease, and select the optimal set of endpoints. The experience of the conducted research leads to an understanding of the need to develop personalized cell therapy, according to which the choice of the source of cells and the route of administration should be based on the individual characteristics of the patient.The growing number of clinical trials and the active study of the mechanisms of action of transplanted cells on damaged myocardium suggest that this type of cell therapy has a chance to enter clinical practice in the near future.Received 4 October 2021. Revised 13 December 2021. Accepted 20 December 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Contribution of the authors: The authors contributed equally to this article.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80305111","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}

{"title":"The results of the application of a new technique of open implantation of self-opening transcatheter aortic valves in an experiment","authors":"M. Zhulkov, K. Kozyr, I. Zykov, A. Tarkova, H. Agaeva, A. Sabetov, D. Sirota, D. Sergeevichev, A. Chernyavskiy","doi":"10.21688/1681-3472-2022-2-49-57","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-49-57","url":null,"abstract":"Background. In recent years, transcatheter implantation of the aortic valve has become increasingly performed as an alternative to \"open\" prosthetics. The undoubted advantage of this technology is its minimally invasive nature, which in most cases provides a favorable clinical outcome of the intervention. The transcatheter method of aortic valve prosthetics does not require sternotomy and connection of an artificial circulation device, which significantly reduces the risk of postoperative mortality and complications. However, despite all the advantages of the existing models, they are not without drawbacks that force researchers to develop and test new transcatheter valves. The problem of experimental studies of new models of self-opening transcatheter aortic valves is mainly determined by the anatomical features of the aortic root of animals. In this regard, the development of a reliable method of implantation of valve prostheses in the experiment is an urgent problem of preclinical testing.Aim. Development of a protocol for open implantation of a transcatheter aortic valve in experiment and evaluation of long-term results.Methods. To develop an experimental model, pigs of the \"Landras\" breed, females weighing 129.83 ± 9 kg were used. Transcatheter aortic valve implantation was performed under conditions of artificial circulation and moderate hypothermia (33-34°C) through a transverse aortotomy under the control of vision. During the experiment, invasive monitoring of blood pressure, central venous pressure, heart rhythm, body temperature, blood gas composition, activated clotting time was performed. The correct positioning and hemodynamic parameters after implantation were evaluated using transesophageal echocardiography.Results. In a series of chronic experiments, 18 open implantations of self-opening transcatheter aortic valves were performed. Successful positioning was achieved in 100% of cases. The developed protocol of open implantation made it possible to achieve reliable fixation of the prosthesis in the orthotopic position, as well as to prevent the migration of the prosthesis, the development of mitral regurgitation, paraaortic fistulas and coronary circulation disorders.Conclusion. In the course of the study, a simple and effective method of open implantation of a transcatheter aortic heart valve prosthesis was developed in an experiment.Received 1 October 2021. Revised 1 November 2021. Accepted 12 November 2021.Funding: This work was carried out within the framework of the state task of Ministry of Health of Russian Federation No. 121032300337-5.Conflict of interest: Authors declare no conflict of interest.Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, K.V. Kozyr, D.S. SergeevichevData collection and analysis: M.O. Zhulkov. Drafting the article: M.O. ZhulkovCritical revision of the article: D.A. Sirota, A.M. ChernyavskiyExperimental part: M.O. Zhulkov, H.A. Agaeva, A.K. Sabetov, I.S. Zykov, A.R. Ta","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84416670","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}

{"title":"A prospective randomized trial of the use of drug-eluting balloon catheters for the treatment of a lateral branch in patients with true bifurcation lesions","authors":"T. K. Eraliev, D. Khelimskii, O. Krestyaninov","doi":"10.21688/1681-3472-2022-2-86","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-86","url":null,"abstract":"Background. Endovascular interventions for bifurcation lesions of the coronary arteries account for approximately 15-20% of all coronary interventions. Despite the use of drug-eluting stents, the management of bifurcation lesions remains challenging, especially in the setting of lateral branch involvement. Although the Provisional stenting strategy is the preferred method for most patients, several studies have shown that dual-stent techniques may be advantageous in this patient population. However, as a general approach, the European Bifurcation Club recommends that percutaneous coronary interventions be performed with a minimum number of stents.Aim. To evaluate the safety and efficacy of using a paclitaxel-coated balloon in the treatment of a lateral branch in patients with true bifurcation coronary disease.Methods. This work was performed as a result of a clinical analysis and evaluation of the results of treatment of 80 patients with coronary artery disease, who underwent stenting of a true bifurcation lesion in the period from 2020 to 2021. All patients were randomized in a 1:1 ratio to main branch stenting followed by lateral branch dilatation with drug-eluting balloons and provisional stenting. A direct angiographic analysis was carried out before and after the intervention, and control coronary angiography was performed 12 months later with an assessment of the results obtained. All patients underwent a comprehensive clinical, laboratory and instrumental examination.Results. Pre-procedure reference main branch diameters were 2.97 ± 0.41 mm and 3.12 ± 0.38 mm in the Provisional and drug-eluting balloons groups, respectively. The degree of stenosis of the main branch before percutaneous coronary interventions was 65.2 ± 14.1% and decreased to 13.3 ± 6.6% after intervention in the Provisional stenting group. This was comparable to the results of percutaneous coronary interventions in the group of patients who used drug-eluting balloons 63.8 ± 12.3% and 12.9 ± 5.8%, respectively. The minimum diameter of the main branch after percutaneous coronary interventions increased from 1.04 ± 0.34 mm to 2.72 ± 0.44 mm in the Provisional stenting group and subsequently decreased to 2.18 ± 0.33 mm, according to control coronary angiography after 12 months. At the same time, patients who underwent intervention using drug-eluting balloons had a smaller loss of the lumen of the main branch 0.41 ± 0.33 mm versus 0.63 ± 0.32 mm (p = 0.003). In addition, late loss of lumen both in the lateral branch (0.51 ± 0.22 mm versus 0.33 ± 0.24 mm) and total in both branches of the bifurcation (1.06 ± 0.29 mm versus 0.79 ± 0.27 mm) was statistically greater with Provisional stenting.Conclusion. Treatment of bifurcation lesions using the Provisional technique with drug-eluting lateral branch dilatation has shown better results than with conventional balloons. ","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87805726","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}

{"title":"Case report of a multidisciplinary approach to one-time treatment of a patient with critical aortic valve stenosis, lesion of the left main coronary artery and bleeding stomach cancer","authors":"B. Alekyan, D. Ruchkin, N. Karapetyan, N. L. Irodova, N. N. Meleshenko, L. Geletsyan, A. Revishvili","doi":"10.21688/1681-3472-2022-2-58-65","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-58-65","url":null,"abstract":"Aortic valve stenosis and bleeding gastric cancer are formidable diseases characterized by high mortality. For a long time, the gold standard for treating patients with aortic stenosis has been open-heart surgery — aortic valve replacement. However, the endovascular operation that appeared in 2002 — transcatheter aortic valve implantation (TAVI) has become the standard of care for patients with high surgical risk. Gastric cancer is one of the major severe oncological diseases in which surgery is the only way to cure. The combination of these two diseases significantly worsens the prognosis and is a difficult clinical task for choosing the optimal tactics for treating a patient. Given the lack of developed standards for the treatment of multimorbid patients, the treatment plan is determined by an interdisciplinary consultation. But with a combination of these diseases, there is no generally accepted approach in the known recommendations.The purpose of this report is to present a clinical case of a patient with critical aortic stenosis, concomitant severe coronary artery disease, and bleeding stomach cancer, who underwent a successful one-stage operation — percutaneous coronary intervention, TAVI and open gastrectomy with Roux-loop reconstruction with one anesthetic aid by the decision of a multidisciplinary team. The patient was discharged in a satisfactory condition. In the late follow-up period, angina pectoris returned with restenosis of the stent in the anterior interventricular branch (LAD), which required repeated intervention in the form of LAD restenting with a good clinical result.A hybrid approach in the treatment of patients with critical aortic valve stenosis in combination with coronary artery disease and bleeding gastric cancer can be accepted as one of the possible strategies, but further research is needed in this direction.Received 15 October 2021. Revised 20 January 2022. Accepted 31 January 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: Authors declare no conflict of interest.Contribution of the authorsLiterature review: N.L. Irodova, L.G. GeletsyanDrafting the article: N.G. Karapetyan, N.N. MeleshenkoCritical revision of the article: B.G. Alekyan, A.Sh. RevishviliSurgical treatment: B.G. Alekyan, D.V. Ruchkin, N.G. Karapetyan, N.N. MeleshenkoFinal approval of the version to be published: B.G. Alekyan, D.V. Ruchkin, N.G. Karapetyan, N.L. Irodova, N.N. Meleshenko, L.G. Geletsyan, A.Sh. Revishvili","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87331509","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}

{"title":"Study about animal (NZW Rabbit, Juvenile pig) test to secure safety and effectiveness of thermoplastic polyurethane stent graft & graft using electrospinning","authors":"H. Kim, C. Moon, J.I. Kim, S. Kang, J. Park, B. Lee","doi":"10.21688/1681-3472-2022-2-93","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-2-93","url":null,"abstract":"Background. A stent is a cylindrical medical device used to normalize the flow of blood or body fluids, such as blood vessels, gastrointestinal tract, and bile duct, by inserting it into a narrowed or blocked area under image fluoroscopy without performing a surgical operation when the flow is not smooth. In particular, stents applied to blood vessels are divided into stents for coronary arteries, stents for blood vessels, stents for blood vessels in the brain, stents for iliac arteries, and stents made of absorbent materials. It is used to improve blood flow.Coronary artery disease refers to a lesion in which blood flow to the myocardium is impaired due to stenosis of the coronary arteries due to atherosclerosis. Atherosclerotic coronary artery disease has long been known as the most common cause of death in the West. Although it has not yet occurred frequently in the East, including Korea, it is reported that coronary artery disease is on the rise with the recent change in eating habits. Coronary artery disease is clinically manifested in one of three aspects: angina pectoris, myocardial infarction, and sudden death. Double myocardial infarction is usually caused by sudden thrombus in a coronary artery with atherosclerotic stenosis, resulting in complete blockage of myocardial blood flow. Myocardial infarction, which was supplied by blood vessels from blocked blood vessels, leads to necrosis. In order to improve blood flow in blood vessels blocked from blood supply due to myocardial infarction, stenting is in the spotlight along with surgical methods. Among the causes of blocking the flow of blood vessels, thrombus is seen as the main cause, so the frequency of using vascular stents with suppressed thrombus formation is increasing.Results. A coronary stent is a medical device used to improve blood flow by expanding a coronary artery narrowed by the formation of a thrombus, and is an intermediary procedure that minimizes side effects through surgery. Among the causes of blocking the flow of blood vessels, thrombus fish are seen as the main cause, so the frequency of using vascular stents with suppressed thrombus formation is increasing. S&G Biotech Research Institute is developing a self-expanding Nitinol stent graft that can ensure patency while suppressing the formation of blood clots. The graft material used here is a material that hardly decomposes in bodily fluids such as blood by using a thermoplastic polyurethane material, and is loaded with an antithrombotic agent. Our research team produced a stent graft by spinning the TPU graft onto the self-expanding Nitinol stent skeleton with an electrospinning device, and confirmed its safety and effectiveness by conducting a biological safety evaluation and animal testing. In addition to the vascular stent for the coronary artery for the treatment of coronary artery disease, the frequency of application of the aortic vascular stent graft for the treatment of aortic vascular disease is also increa","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89203270","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}