Pub Date : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/dt031-2533
I. Dziuryi, I. Truba, Oleksandr S. Golovenko, I. Perepeka, V. Lazoryshynets
Ebstein’s anomaly (EA) is a rare and complex congenital heart disease, with a prevalence of 4 to 7 cases per 100,000 live births. At this stage of the development of EA surgery, significant progress has been made in our understanding and treatment of EA, but the question of the tactics of treating complex forms, especially in the period of infancy and early childhood, remains open. Due to significant phenotypic heterogeneity, the treatment of EA varies greatly from patient to patient and depends on many factors that require a comprehensive approach. The choice of the method of surgical correction directly depends on the anatomical features: the degree of dysplasia, rotation and displacement of the tricuspid valve, the degree of atrialization of the right ventricle, the combination with other congenital heart diseases, and the severity of hemodynamic disorders. The aim. To evaluate perioperative characteristics in patients with complex forms of EA, immediate and long-term results after hemodynamic correction. Materials and methods. In the period from 1996 to 2022, at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, one and a half ventricle repair was performed in 18 patients with complex forms of EA. There were 12 (67%) male patients, 6 (33%) female patients. The median age of the patients at the time of surgery was 30 months [3.5; 312]. The main diagnostic method in determining the defect and assessing the immediate and remote results was echocardiography and probing of the heart cavities. In order to qualitatively evaluate the perioperative, immediate and long-term results to determine the optimal tactics and terms of surgical intervention, prevention of possible complications, all the patients were divided into two age groups: I group up to 2.5 years including 9 patients (50%), II group older than 2.5 years including 9 patients (50%). Results. In the postoperative period, 2 (11%) deaths were noted in both groups. In all the deceased patients, the cause of death was acute heart failure and acute respiratory failure. The analysis of the postoperative period showed normal results in such a cohort of highly complex patients of both groups, but a more stable course was noted among patients of the I group, as indicated by statistically significant values for the duration of mechanical ventilation, stay in the intensive care unit, stay in the hospital, the average dose of sympathomimetic support and its duration, the total duration of exudation in the comparison groups. An uncomplicated course of the early postoperative period was observed in 8 (44%) patients. The remaining 10 (56%) patients of both groups had: I group, 3 (33%) patients: 7 complications; II group, 5 (55%) patients: 13 complications. In 5 patients (2 patients in I group and 3 patients in II group), attention-grabbing acute heart failure was observed, which required high doses and long-term sympathomimetic support, and i
{"title":"Experience of Surgical Treatment of Complex Forms of Ebstein’s Anomaly through the Method of Hemodynamic Correction","authors":"I. Dziuryi, I. Truba, Oleksandr S. Golovenko, I. Perepeka, V. Lazoryshynets","doi":"10.30702/ujcvs/23.31(02)/dt031-2533","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/dt031-2533","url":null,"abstract":"Ebstein’s anomaly (EA) is a rare and complex congenital heart disease, with a prevalence of 4 to 7 cases per 100,000 live births. At this stage of the development of EA surgery, significant progress has been made in our understanding and treatment of EA, but the question of the tactics of treating complex forms, especially in the period of infancy and early childhood, remains open. Due to significant phenotypic heterogeneity, the treatment of EA varies greatly from patient to patient and depends on many factors that require a comprehensive approach. The choice of the method of surgical correction directly depends on the anatomical features: the degree of dysplasia, rotation and displacement of the tricuspid valve, the degree of atrialization of the right ventricle, the combination with other congenital heart diseases, and the severity of hemodynamic disorders. \u0000The aim. To evaluate perioperative characteristics in patients with complex forms of EA, immediate and long-term results after hemodynamic correction. \u0000Materials and methods. In the period from 1996 to 2022, at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, one and a half ventricle repair was performed in 18 patients with complex forms of EA. There were 12 (67%) male patients, 6 (33%) female patients. The median age of the patients at the time of surgery was 30 months [3.5; 312]. The main diagnostic method in determining the defect and assessing the immediate and remote results was echocardiography and probing of the heart cavities. In order to qualitatively evaluate the perioperative, immediate and long-term results to determine the optimal tactics and terms of surgical intervention, prevention of possible complications, all the patients were divided into two age groups: I group up to 2.5 years including 9 patients (50%), II group older than 2.5 years including 9 patients (50%). \u0000Results. In the postoperative period, 2 (11%) deaths were noted in both groups. In all the deceased patients, the cause of death was acute heart failure and acute respiratory failure. The analysis of the postoperative period showed normal results in such a cohort of highly complex patients of both groups, but a more stable course was noted among patients of the I group, as indicated by statistically significant values for the duration of mechanical ventilation, stay in the intensive care unit, stay in the hospital, the average dose of sympathomimetic support and its duration, the total duration of exudation in the comparison groups. \u0000An uncomplicated course of the early postoperative period was observed in 8 (44%) patients. The remaining 10 (56%) patients of both groups had: I group, 3 (33%) patients: 7 complications; II group, 5 (55%) patients: 13 complications. In 5 patients (2 patients in I group and 3 patients in II group), attention-grabbing acute heart failure was observed, which required high doses and long-term sympathomimetic support, and i","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44139317","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/kss012-8588
Dinesh Kumar Sathanantham, Spurthi Sanganbhonia, C. Shashirekha, P. Sreeramulu
Surgical emphysema, also widely known as subcutaneous emphysema, is defined as a clinical state in which air gets trapped subcutaneously. The etiology may be traumatic or atraumatic, and multiple causes in each are present. Case report. A 63-year-old female patient presented to the emergency room with a facial soft tissue injury following road traffic accident and developed surgical emphysema later on with no evidence of rib fractures or pneumothorax. Infectious etiology was ruled out. Due to the respiratory embarrassment, the patient was electively intubated. Conservative management was provided. Emphysema resolved within 24 hours after the accident. Discussion. Various theories have been outlined in literature, like Mackler effect, Crampton theory and ballvalve mechanism. In our case, it was difficult to apply any of these theories to confirm the diagnosis. Conservative management is still used in the treatment of surgical emphysema. Conclusion. Surgical emphysema is a common encounter in trauma practice, and its identification is essential to rule out any emergency causes which may lead to respiratory distress.
{"title":"Surgical Emphysema without Pneumothorax: A Diagnostic Dilemma","authors":"Dinesh Kumar Sathanantham, Spurthi Sanganbhonia, C. Shashirekha, P. Sreeramulu","doi":"10.30702/ujcvs/23.31(02)/kss012-8588","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/kss012-8588","url":null,"abstract":"Surgical emphysema, also widely known as subcutaneous emphysema, is defined as a clinical state in which air gets trapped subcutaneously. The etiology may be traumatic or atraumatic, and multiple causes in each are present. \u0000Case report. A 63-year-old female patient presented to the emergency room with a facial soft tissue injury following road traffic accident and developed surgical emphysema later on with no evidence of rib fractures or pneumothorax. Infectious etiology was ruled out. Due to the respiratory embarrassment, the patient was electively intubated. Conservative management was provided. Emphysema resolved within 24 hours after the accident. \u0000Discussion. Various theories have been outlined in literature, like Mackler effect, Crampton theory and ballvalve mechanism. In our case, it was difficult to apply any of these theories to confirm the diagnosis. Conservative management is still used in the treatment of surgical emphysema. \u0000Conclusion. Surgical emphysema is a common encounter in trauma practice, and its identification is essential to rule out any emergency causes which may lead to respiratory distress.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42908710","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/pp018-5057
V. F. Petrov, M. Pankiv
Extended reality combines the real and digital worlds. This technology has found applications in all fields of medicine, including cardiac surgery and interventional cardiology. The paper describes the application of three types of extended reality, namely virtual, augmented and mixed realities. The aim. To explain the principles of operation of various types of extended reality using non-medical and medical applications as examples; to analyze the data from specialized publications in the field of cardiac interventions. Materials. Articles from the Pubmed database. Results. The article highlights important details of the heart and blood vessels image creation technique with which users operate. Primary data is obtained from imaging modalities like tomography or ultrasound, then it is segmented and processed for the virtual viewing. In virtual reality, three-dimensional (3D) images of the heart defects are analyzed in depth, and virtual manipulations can be performed that simulate the course of the operation. Virtual reality includes printing the heart on a 3D printer with subsequent executions on physical models, both diagnostic dissections and therapeutic surgical or endovascular simulations. In augmented reality, the created image of the internal anatomy of the defect is present near the surgeon, without interfering medical manipulations. In mixed reality, a virtual image is superimposed on the patient’s body, creating a detailed navigation map. Conclusions. Extended reality application deepens the understanding of anatomy due to stereoscopic visualization of the structure of the heart and blood vessels. Creating a model of a patient’s heart defect and simulating an operation on it shortens the “learning curve”, improves the professional skills of surgeons and cardiologists, and also allows for surgical and endovascular interventions individualization. Planning interventions in cardiac surgery and interventional cardiology with extended reality technologies influences decision-making and reduces the duration of operations.
{"title":"Extended Reality Applications in Cardiac Surgery and Interventional Cardiology","authors":"V. F. Petrov, M. Pankiv","doi":"10.30702/ujcvs/23.31(02)/pp018-5057","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/pp018-5057","url":null,"abstract":"Extended reality combines the real and digital worlds. This technology has found applications in all fields of medicine, including cardiac surgery and interventional cardiology. The paper describes the application of three types of extended reality, namely virtual, augmented and mixed realities. \u0000The aim. To explain the principles of operation of various types of extended reality using non-medical and medical applications as examples; to analyze the data from specialized publications in the field of cardiac interventions. \u0000Materials. Articles from the Pubmed database. \u0000Results. The article highlights important details of the heart and blood vessels image creation technique with which users operate. Primary data is obtained from imaging modalities like tomography or ultrasound, then it is segmented and processed for the virtual viewing. In virtual reality, three-dimensional (3D) images of the heart defects are analyzed in depth, and virtual manipulations can be performed that simulate the course of the operation. Virtual reality includes printing the heart on a 3D printer with subsequent executions on physical models, both diagnostic dissections and therapeutic surgical or endovascular simulations. In augmented reality, the created image of the internal anatomy of the defect is present near the surgeon, without interfering medical manipulations. In mixed reality, a virtual image is superimposed on the patient’s body, creating a detailed navigation map. \u0000Conclusions. Extended reality application deepens the understanding of anatomy due to stereoscopic visualization of the structure of the heart and blood vessels. Creating a model of a patient’s heart defect and simulating an operation on it shortens the “learning curve”, improves the professional skills of surgeons and cardiologists, and also allows for surgical and endovascular interventions individualization. Planning interventions in cardiac surgery and interventional cardiology with extended reality technologies influences decision-making and reduces the duration of operations.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42833300","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/ut015-6872
O. Usenko, O. S. Tyvonchuk, R. Vynogradov, D. Zhytnik
Morgagni-Larrey hernia is a rare form of diaphragmatic hernia (2-5% of cases) usually diagnosed in children; in adults, it is often detected in emergency cases or accidentally, during examinations or during surgery. The symptoms of the disease are non-specific, so the diagnosis is made using imaging methods (computed tomography is the gold standard). Currently, there is no single method of treating Morgagni-Larrey hernias. Closure of the defect is performed with or without the use of various mesh prostheses through the abdominal or thoracic route; open or minimally invasive access. The aim. To conduct a retrospective analysis of the treatment of adult patients with a Morgagni-Larrey diaphragmatic hernia, including those with cardiovascular comorbidity, with a comparison of symptoms, contents of the hernial sac, with the use of laparoscopic techniques and composite mesh prostheses. Materials and methods. The results of the treatment of three patients with a Morgagni-Larrey hernia in the period from 2020 to 2022 at the Shalimov National Institute of Surgery and Transplantation are shown. In two patients, the content of the hernial sac was a loop of the transverse colon, in one, the content of the hernial sac was a greater omentum. Taking into account the accompanying cardiovascular pathology, an interdisciplinary council consisting of a surgeon, anesthesiologist, and cardiologist recommended laparoscopic surgical intervention. Laparoscopic allogeneoplasty with composite prosthesis implantation was performed in three patients. Conclusions. The laparoscopic method of treating diaphragmatic hernias is safe and effective. The use of composite prostheses in combination with tension closure of the defect allows to reduce the risk of recurrence of the disease in the distant postoperative period.
{"title":"Laparoscopic Treatment of Morgagni-Larrey Diaphragmatic Hernia with Reposition of the Transverse Colon in Patients with Cardiac Comorbidity. Clinical Observation","authors":"O. Usenko, O. S. Tyvonchuk, R. Vynogradov, D. Zhytnik","doi":"10.30702/ujcvs/23.31(02)/ut015-6872","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/ut015-6872","url":null,"abstract":"Morgagni-Larrey hernia is a rare form of diaphragmatic hernia (2-5% of cases) usually diagnosed in children; in adults, it is often detected in emergency cases or accidentally, during examinations or during surgery. The symptoms of the disease are non-specific, so the diagnosis is made using imaging methods (computed tomography is the gold standard). Currently, there is no single method of treating Morgagni-Larrey hernias. Closure of the defect is performed with or without the use of various mesh prostheses through the abdominal or thoracic route; open or minimally invasive access. \u0000The aim. To conduct a retrospective analysis of the treatment of adult patients with a Morgagni-Larrey diaphragmatic hernia, including those with cardiovascular comorbidity, with a comparison of symptoms, contents of the hernial sac, with the use of laparoscopic techniques and composite mesh prostheses. \u0000Materials and methods. The results of the treatment of three patients with a Morgagni-Larrey hernia in the period from 2020 to 2022 at the Shalimov National Institute of Surgery and Transplantation are shown. In two patients, the content of the hernial sac was a loop of the transverse colon, in one, the content of the hernial sac was a greater omentum. Taking into account the accompanying cardiovascular pathology, an interdisciplinary council consisting of a surgeon, anesthesiologist, and cardiologist recommended laparoscopic surgical intervention. Laparoscopic allogeneoplasty with composite prosthesis implantation was performed in three patients. \u0000Conclusions. The laparoscopic method of treating diaphragmatic hernias is safe and effective. The use of composite prostheses in combination with tension closure of the defect allows to reduce the risk of recurrence of the disease in the distant postoperative period.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43884038","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/gr026-7884
O. Gogayeva, S. A. Rudenko, O. Nudchenko, S. V. Fedkiv
Postinfarction left ventricular (LV) aneurysm develops as a result of untimely restoration of blood flow in the infarct-dependent artery and is associated with an increase in cardiac mortality. The presence of several postinfarction LV aneurysms of different localizations in one patient is a rare and casuistic case. Case description. Patient B., 53 years old, was urgently hospitalized in the National Amosov Institute with complaints of shortness of breath, pain behind the sternum with radiation to the left arm, occurring with minimal physical exertion. Electrocardiography showed scar changes in the anterior-apical-lateral area of the LV with a thrombosed aneurysm of the LV lateral wall. Echocardiography revealed a severe decrease in the global contractility of the LV with ejection fraction of 24% and aneurysms of the septal-apical and posterior-lateral segments of LV. Pericarditis was found, with a layer of fluid of 1.7 cm on the LV posterior wall and 2.0 cm on the LV apex. Emergency coronary angiography revealed an occlusion of the middle third of the left anterior descending artery and the middle third of the left circumflex coronary artery, 50-70% stenosis of the right coronary artery and confirmed widespread LV aneurysm. Cardiac magnetic resonance imaging with intravenous contrast confirmed the change in configuration and significant dilatation of the LV due to the formation of two LV aneurysms with mural thrombus in the cavity of the posterior-lateral LV aneurysm. After discussing the patient’s data, the cardiac team performed emergency on-pump coronary bypass surgery, resection of the LV aneurysm with thrombectomy. The operation took 5 hours, aorta cross-clamp time was 75 min, perfusion time was 117 min, intraoperative blood loss was 300 ml. The patient was extubated in 2 hours after the end of the operation, the length of intensive care unit stay was 2 days. On the 9th day after the operation, the patient was discharged from the Institute with positive clinical, electrocardiographic and echocardiographic (LV ejection fraction 38%) dynamics. Conclusions. This clinical case demonstrates successful surgical treatment of two LV aneurysms, a rare complication of acute myocardial infarction. Preoperative detailed diagnosis and discussion of the patient’s data by the heart team, selection of the optimal term and volume of the operation allowed to quickly stabilize the patient’s condition and achieve a positive immediate result.
{"title":"A Clinical Case of Surgical Treatment of a Patient with Two Postinfarction Left Ventricular Aneurysms","authors":"O. Gogayeva, S. A. Rudenko, O. Nudchenko, S. V. Fedkiv","doi":"10.30702/ujcvs/23.31(02)/gr026-7884","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/gr026-7884","url":null,"abstract":"Postinfarction left ventricular (LV) aneurysm develops as a result of untimely restoration of blood flow in the infarct-dependent artery and is associated with an increase in cardiac mortality. The presence of several postinfarction LV aneurysms of different localizations in one patient is a rare and casuistic case. \u0000Case description. Patient B., 53 years old, was urgently hospitalized in the National Amosov Institute with complaints of shortness of breath, pain behind the sternum with radiation to the left arm, occurring with minimal physical exertion. Electrocardiography showed scar changes in the anterior-apical-lateral area of the LV with a thrombosed aneurysm of the LV lateral wall. Echocardiography revealed a severe decrease in the global contractility of the LV with ejection fraction of 24% and aneurysms of the septal-apical and posterior-lateral segments of LV. Pericarditis was found, with a layer of fluid of 1.7 cm on the LV posterior wall and 2.0 cm on the LV apex. Emergency coronary angiography revealed an occlusion of the middle third of the left anterior descending artery and the middle third of the left circumflex coronary artery, 50-70% stenosis of the right coronary artery and confirmed widespread LV aneurysm. Cardiac magnetic resonance imaging with intravenous contrast confirmed the change in configuration and significant dilatation of the LV due to the formation of two LV aneurysms with mural thrombus in the cavity of the posterior-lateral LV aneurysm. After discussing the patient’s data, the cardiac team performed emergency on-pump coronary bypass surgery, resection of the LV aneurysm with thrombectomy. The operation took 5 hours, aorta cross-clamp time was 75 min, perfusion time was 117 min, intraoperative blood loss was 300 ml. The patient was extubated in 2 hours after the end of the operation, the length of intensive care unit stay was 2 days. On the 9th day after the operation, the patient was discharged from the Institute with positive clinical, electrocardiographic and echocardiographic (LV ejection fraction 38%) dynamics. \u0000Conclusions. This clinical case demonstrates successful surgical treatment of two LV aneurysms, a rare complication of acute myocardial infarction. Preoperative detailed diagnosis and discussion of the patient’s data by the heart team, selection of the optimal term and volume of the operation allowed to quickly stabilize the patient’s condition and achieve a positive immediate result.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49053736","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/vi017-7377
R. M. Vitovskyi, V. Isaienko, A. R. Vitovskyi, O. V. Satmari, Inna G. Yakovenko, N. Volkova
Background. The stage 4 mitral stenosis is accompanied by atrial fibrillation which significantly worsens the prognosis due to the possibility of thromboembolic complications. However, sinus rhythm does not exclude the possibility of thrombosis which sometimes requires differential diagnosis with heart tumors. The aim. To present a case of unusual thrombus formation in a patient with significant mitral stenosis on the background of sinus rhythm and describe the specifics of determining indications for surgical intervention. Case report. Female patient K., 42 years old, who was admitted on January 12, 2023 to the National Amosov Institute of Cardiovascular Surgery, had been suffering from rheumatism for the past 20 years. In this case, the clinical course of mitral stenosis could be classified as stage 4, since there were signs of severe heart failure (shortness of breath on light exertion, peripheral edema, right-sided pleuritis, pulmonary thrombosis). However, the patient had sinus rhythm, which is more characteristic of the stage 3 mitral stenosis. The patient underwent mitral valve prosthetic surgery and removal of an unusual thrombus from the pulmonary valve cavity on January 23, 2023. Conclusions. The course of mitral stenosis, despite its thorough study, may have unusual clinical and instrumental manifestations, which requires differential diagnosis with heart tumors and other diseases. In some cases, the mechanism of thrombus formation can be extremely unusual, which can be a subject for discussion by cardiologists.
{"title":"A Case of an Unusual Clinical Course of Mitral Stenosis","authors":"R. M. Vitovskyi, V. Isaienko, A. R. Vitovskyi, O. V. Satmari, Inna G. Yakovenko, N. Volkova","doi":"10.30702/ujcvs/23.31(02)/vi017-7377","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/vi017-7377","url":null,"abstract":"Background. The stage 4 mitral stenosis is accompanied by atrial fibrillation which significantly worsens the prognosis due to the possibility of thromboembolic complications. However, sinus rhythm does not exclude the possibility of thrombosis which sometimes requires differential diagnosis with heart tumors. \u0000The aim. To present a case of unusual thrombus formation in a patient with significant mitral stenosis on the background of sinus rhythm and describe the specifics of determining indications for surgical intervention. \u0000Case report. Female patient K., 42 years old, who was admitted on January 12, 2023 to the National Amosov Institute of Cardiovascular Surgery, had been suffering from rheumatism for the past 20 years. In this case, the clinical course of mitral stenosis could be classified as stage 4, since there were signs of severe heart failure (shortness of breath on light exertion, peripheral edema, right-sided pleuritis, pulmonary thrombosis). However, the patient had sinus rhythm, which is more characteristic of the stage 3 mitral stenosis. The patient underwent mitral valve prosthetic surgery and removal of an unusual thrombus from the pulmonary valve cavity on January 23, 2023. \u0000Conclusions. The course of mitral stenosis, despite its thorough study, may have unusual clinical and instrumental manifestations, which requires differential diagnosis with heart tumors and other diseases. In some cases, the mechanism of thrombus formation can be extremely unusual, which can be a subject for discussion by cardiologists.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45514591","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/sr020-0915
A. Solomonchuk, L. Rasputina, D. Didenko
The aim of the study was to determine the risk factors for the occurrence of acute heart failure (AHF) of high degrees (Killip classes III and IV) among patients with myocardial infarction (MI). Materials and methods. We examined 308 MI patients who were treated at the specialized cardiology department. The mean age of the subjects was 62.9±0.6 years. There were 161 (52.3%) patients with MI without signs of heart failure (HF) (Killip class I), 44 (14.3%) with MI combined with class II AHF, 55 (17.8%) with MI and class III AHF, and 48 (15.6%) with MI and Killip class IV AHF. In addition to the general clinical examination, all the patients underwent additional laboratory examination (quantitative determination of troponin I, D-dimer, creatine kinase-MB, C-reactive protein, N-terminal prohormone of brain natriuretic peptide [NT-proBNP]), echocardiography and lung ultrasound during hospitalization, as well as coronary angiography. Results. A correlation between the occurrence of class III AHF (pulmonary edema) and class IV AHF (cardiogenic shock) and a number of anamnestic, clinical, functional and laboratory indicators was established. The following predictors of the development of class III AHF among patients with MI were calculated through regression analysis: a decrease in the level of O2 saturation during hospitalization, an increase in blood pressure during hospitalization, localization of the main heart attack-related lesion of the distal part of the right coronary artery, a decrease in the left ventricular ejection fraction. With less significance, predictors of the development of class III AHF were also defined as a decrease in the level of hemoglobin, the duration of hypertension in the history, the degree of hypertension, the history of any form of atrial fibrillation. Conclusions. A decrease in diastolic blood pressure irrespective of medical support and an increase in the level of NT-proBNP were established as predictors of the development of Killip class IV AHF. Further studies to predict the occurrence of HF and long-term consequences after MI with high-grade HF are promising and can provide an opportunity to optimize the treatment of patients by preventing severe complications.
{"title":"Prediction of the Development of Acute Heart Failure of High Grades in Patients with Myocardial Infarction and Percutaneous Coronary Intervention","authors":"A. Solomonchuk, L. Rasputina, D. Didenko","doi":"10.30702/ujcvs/23.31(02)/sr020-0915","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/sr020-0915","url":null,"abstract":"The aim of the study was to determine the risk factors for the occurrence of acute heart failure (AHF) of high degrees (Killip classes III and IV) among patients with myocardial infarction (MI). \u0000Materials and methods. We examined 308 MI patients who were treated at the specialized cardiology department. The mean age of the subjects was 62.9±0.6 years. There were 161 (52.3%) patients with MI without signs of heart failure (HF) (Killip class I), 44 (14.3%) with MI combined with class II AHF, 55 (17.8%) with MI and class III AHF, and 48 (15.6%) with MI and Killip class IV AHF. In addition to the general clinical examination, all the patients underwent additional laboratory examination (quantitative determination of troponin I, D-dimer, creatine kinase-MB, C-reactive protein, N-terminal prohormone of brain natriuretic peptide [NT-proBNP]), echocardiography and lung ultrasound during hospitalization, as well as coronary angiography. \u0000Results. A correlation between the occurrence of class III AHF (pulmonary edema) and class IV AHF (cardiogenic shock) and a number of anamnestic, clinical, functional and laboratory indicators was established. The following predictors of the development of class III AHF among patients with MI were calculated through regression analysis: a decrease in the level of O2 saturation during hospitalization, an increase in blood pressure during hospitalization, localization of the main heart attack-related lesion of the distal part of the right coronary artery, a decrease in the left ventricular ejection fraction. With less significance, predictors of the development of class III AHF were also defined as a decrease in the level of hemoglobin, the duration of hypertension in the history, the degree of hypertension, the history of any form of atrial fibrillation. \u0000Conclusions. A decrease in diastolic blood pressure irrespective of medical support and an increase in the level of NT-proBNP were established as predictors of the development of Killip class IV AHF. Further studies to predict the occurrence of HF and long-term consequences after MI with high-grade HF are promising and can provide an opportunity to optimize the treatment of patients by preventing severe complications.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47553965","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/pb028-1624
V. Popov, O. Bolshak, V. Boukarim, Olena V. Khoroshkovata, O. M. Gurtovenko, Evgen V. Novikov
The aim. To analyze the results of introduction of complex reconstruction of the left and right parts of the heart in Marfan syndrome combined with mitral-tricuspid insufficiency, biatriomegaly and left ventriculomegaly. Materials and methods. As an example of this pathology, we present our observation. Female patient T., 24 years old, was examined and treated from 7/27/2022 to 8/17/2022 at the Department of Surgical Treatment of Acquired Heart Diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a diagnosis: Marfan syndrome. Stage IV mitral-tricuspid insufficiency. Biatriomegaly. High pulmonary hypertension. Permanent form of atrial fibrillation (for 10 years, since 2011). IIB heart failure with left ventriculomegaly with reduced left ventricular ejection fraction. NYHA functional class IV+. The patient underwent surgery in the following volume: mitral valve replacement with full preservation of the valve apparatus + tricuspid valve plasty with the imposition of a support ring + triangular plasty of the left atrium with its partial resection + resection of the right atrium. Results. Within 4 months after surgery, echocardiographic parameters showed significant decrease in the volume of the left ventricle, the diameters of both atria. In addition, there was a significant decrease in the level of N-terminal pro-brain natriuretic peptide and manifestations of heart failure. Conclusion. Taking into account the initial serious condition of the patient with Marfan syndrome and advanced mitral-tricuspid heart disease, left ventriculomegaly with a reduced left ventricular ejection fraction, biatriomegaly (left atrium 7.2 cm, right atrium 6.5 cm), permanent form of atrial fibrillation, complex reconstruction of the left and right parts of the heart leads to an improvement in the functional state of the myocardium.
{"title":"Surgical Reconstruction of Mitral-Tricuspid Insufficiency Combined with Biatriomegaly in Marfan Syndrome","authors":"V. Popov, O. Bolshak, V. Boukarim, Olena V. Khoroshkovata, O. M. Gurtovenko, Evgen V. Novikov","doi":"10.30702/ujcvs/23.31(02)/pb028-1624","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/pb028-1624","url":null,"abstract":"The aim. To analyze the results of introduction of complex reconstruction of the left and right parts of the heart in Marfan syndrome combined with mitral-tricuspid insufficiency, biatriomegaly and left ventriculomegaly. \u0000Materials and methods. As an example of this pathology, we present our observation. Female patient T., 24 years old, was examined and treated from 7/27/2022 to 8/17/2022 at the Department of Surgical Treatment of Acquired Heart Diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a diagnosis: Marfan syndrome. Stage IV mitral-tricuspid insufficiency. Biatriomegaly. High pulmonary hypertension. Permanent form of atrial fibrillation (for 10 years, since 2011). IIB heart failure with left ventriculomegaly with reduced left ventricular ejection fraction. NYHA functional class IV+. The patient underwent surgery in the following volume: mitral valve replacement with full preservation of the valve apparatus + tricuspid valve plasty with the imposition of a support ring + triangular plasty of the left atrium with its partial resection + resection of the right atrium. \u0000Results. Within 4 months after surgery, echocardiographic parameters showed significant decrease in the volume of the left ventricle, the diameters of both atria. In addition, there was a significant decrease in the level of N-terminal pro-brain natriuretic peptide and manifestations of heart failure. \u0000Conclusion. Taking into account the initial serious condition of the patient with Marfan syndrome and advanced mitral-tricuspid heart disease, left ventriculomegaly with a reduced left ventricular ejection fraction, biatriomegaly (left atrium 7.2 cm, right atrium 6.5 cm), permanent form of atrial fibrillation, complex reconstruction of the left and right parts of the heart leads to an improvement in the functional state of the myocardium.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48993609","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/pt024-3444
E. O. Perepeka, O. Trembovetska, B. Kravchuk, I. Nastenko, M. Sychyk
Right ventricular pacing may impair left ventricular systolic function in patients with reduced left ventricular ejection fraction (LVEF). The aim. To determine the frequency of pacing-induced cardiomyopathy (PICM) in patients with permanent right ventricular pacing (at least 90%) and preserved LVEF (≥50%). To determine the risk factors for the occurrence of PICM. Materials and methods. The study included 34 patients with indications for permanent ventricular pacing in whom pacemaker was implanted from 2012 to 2022 (mean follow-up period 44.97 ± 28.45 months). PICM was defined as a decrease in LVEF <45% during follow-up regardless of clinical manifestations. Risk factors for PICM were determined through univariate and multivariate regression analysis. Results. The incidence of PICM in this study was 26% during the mean observation period of 44.9 ± 28.4 months. The mean time to the onset of PICM was 29 months in 5 out of 9 patients (55%), the time from implantation to diagnosis of PICM was less than a year. The mean LVEF and end-diastolic volume index at the time of follow-up differed significantly in the groups with and without PICM: 38.6 ± 5.9% vs. 53.5 ± 5.7% (p<0.001) and 97.9 ± 20.75 ml/m2 vs. 60.9 ± 19.32 ml/m2 (p<0.001), respectively. In the PICM group intraventricular asynchrony was 261.1 ± 61 ms vs. 146.1 ± 62.8 ms (p<0.001), interventricular asynchrony 91 ± 36.4 ms vs. 54.2 ± 22.2 ms (p = 0.014), the number of segments with reduced deformation 8.1 ± 2.6 vs. 3.91 ± 2.3 (p<0.001), global longitudinal strain –9.7 ± 2.6 % vs. –14.9 ± 3.4 % (p<0.001). At the time of the follow-up examination, the signal of sensitivity on ventricular lead in the PICM group was significantly reduced compared to patients without PICM (6.26 ± 4.02 mV vs. 11.56 ± 3.86 mV, p = 0.045). Paced QRS width in the PICM group was significantly larger (163 ± 22.7 ms vs. 150.8 ± 14.5 ms) and there were more patients with rate-adapted cardiac pacing in the PICM group: 4 (40%) vs. 2 (8%) (p = 0.0428). In multivariate regression analysis, a wider paced QRS (hazard ratio 1.09 for every 1 ms increment in QRS width, 95% confidence interval 1.01-1.17, p = 0.025) was an independent predictor of PICM. In two patients from PICM group, upgrade of pacemaker system to biventricular pacing was performed with an improvement in the left ventricular contractility: in one patient from 37% to 44%, in another from 34% to 51% in one and two month, respectively. Conclusions. Cardiomyopathy due to right ventricular pacing tends to occur instantaneously in the first years after pacemaker implantation, rather than slowly progressing over time. A wider paced QRS complex is an independent predictor of PICM. Biventricular pacing effectively eliminates the consequences of non-physiological right ventricular pacing, improves left ventricular systolic function.
左心室射血分数(LVEF)降低的患者右心室起搏可能损害左心室收缩功能。的目标。确定永久性右心室起搏(至少90%)和LVEF保存(≥50%)患者起搏性心肌病(PICM)的发生频率。确定PICM发生的危险因素。材料和方法。本研究纳入2012年至2022年34例植入起搏器的有适应证的永久性心室起搏患者(平均随访时间44.97±28.45个月)。无论临床表现如何，PICM定义为随访期间LVEF下降<45%。通过单因素和多因素回归分析确定PICM的危险因素。结果。PICM的发生率为26%，平均观察时间为44.9±28.4个月。9例患者中有5例(55%)发生PICM的平均时间为29个月，从植入到诊断PICM的时间少于1年。随访时，有PICM组和无PICM组的平均LVEF和舒张末期容积指数分别为38.6±5.9% vs. 53.5±5.7% (p<0.001)和97.9±20.75 ml/m2 vs. 60.9±19.32 ml/m2 (p<0.001)。PICM组脑室内不同步时间为261.1±61 ms vs. 146.1±62.8 ms (p<0.001)，室间不同步时间为91±36.4 ms vs. 54.2±22.2 ms (p = 0.014)，变形减少节段数为8.1±2.6 vs. 3.91±2.3 (p<0.001)，整体纵向应变为-9.7±2.6% vs. -14.9±3.4% (p<0.001)。随访检查时，PICM组心室导联敏感信号较未PICM组明显降低(6.26±4.02 mV vs. 11.56±3.86 mV, p = 0.045)。PICM组节律性QRS宽度(163±22.7 ms vs 150.8±14.5 ms)明显大于PICM组，PICM组心率适应心脏起搏患者较多:4例(40%)vs 2例(8%)(p = 0.0428)。在多变量回归分析中，更宽的QRS (QRS宽度每增加1 ms，风险比为1.09,95%置信区间为1.01-1.17,p = 0.025)是PICM的独立预测因子。PICM组的2例患者将起搏器系统升级为双心室起搏后，左心室收缩力分别在1个月和2个月内从37%提高到44%，另一例从34%提高到51%。结论。由于右心室起搏引起的心肌病往往在起搏器植入后的头几年立即发生，而不是随着时间的推移缓慢发展。较宽的QRS复合体是PICM的独立预测因子。双室起搏有效消除非生理性右室起搏的后果，改善左室收缩功能。
{"title":"Predictors of Pacing-Induced Cardiomyopathy in Patients with Permanent Right Ventricular Pacing and Preserved Left Ventricular Systolic Function","authors":"E. O. Perepeka, O. Trembovetska, B. Kravchuk, I. Nastenko, M. Sychyk","doi":"10.30702/ujcvs/23.31(02)/pt024-3444","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/pt024-3444","url":null,"abstract":"Right ventricular pacing may impair left ventricular systolic function in patients with reduced left ventricular ejection fraction (LVEF). \u0000The aim. To determine the frequency of pacing-induced cardiomyopathy (PICM) in patients with permanent right ventricular pacing (at least 90%) and preserved LVEF (≥50%). To determine the risk factors for the occurrence of PICM. \u0000Materials and methods. The study included 34 patients with indications for permanent ventricular pacing in whom pacemaker was implanted from 2012 to 2022 (mean follow-up period 44.97 ± 28.45 months). PICM was defined as a decrease in LVEF <45% during follow-up regardless of clinical manifestations. Risk factors for PICM were determined through univariate and multivariate regression analysis. \u0000Results. The incidence of PICM in this study was 26% during the mean observation period of 44.9 ± 28.4 months. The mean time to the onset of PICM was 29 months in 5 out of 9 patients (55%), the time from implantation to diagnosis of PICM was less than a year. The mean LVEF and end-diastolic volume index at the time of follow-up differed significantly in the groups with and without PICM: 38.6 ± 5.9% vs. 53.5 ± 5.7% (p<0.001) and 97.9 ± 20.75 ml/m2 vs. 60.9 ± 19.32 ml/m2 (p<0.001), respectively. In the PICM group intraventricular asynchrony was 261.1 ± 61 ms vs. 146.1 ± 62.8 ms (p<0.001), interventricular asynchrony 91 ± 36.4 ms vs. 54.2 ± 22.2 ms (p = 0.014), the number of segments with reduced deformation 8.1 ± 2.6 vs. 3.91 ± 2.3 (p<0.001), global longitudinal strain –9.7 ± 2.6 % vs. –14.9 ± 3.4 % (p<0.001). At the time of the follow-up examination, the signal of sensitivity on ventricular lead in the PICM group was significantly reduced compared to patients without PICM (6.26 ± 4.02 mV vs. 11.56 ± 3.86 mV, p = 0.045). Paced QRS width in the PICM group was significantly larger (163 ± 22.7 ms vs. 150.8 ± 14.5 ms) and there were more patients with rate-adapted cardiac pacing in the PICM group: 4 (40%) vs. 2 (8%) (p = 0.0428). In multivariate regression analysis, a wider paced QRS (hazard ratio 1.09 for every 1 ms increment in QRS width, 95% confidence interval 1.01-1.17, p = 0.025) was an independent predictor of PICM. In two patients from PICM group, upgrade of pacemaker system to biventricular pacing was performed with an improvement in the left ventricular contractility: in one patient from 37% to 44%, in another from 34% to 51% in one and two month, respectively. \u0000Conclusions. Cardiomyopathy due to right ventricular pacing tends to occur instantaneously in the first years after pacemaker implantation, rather than slowly progressing over time. A wider paced QRS complex is an independent predictor of PICM. Biventricular pacing effectively eliminates the consequences of non-physiological right ventricular pacing, improves left ventricular systolic function.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45004290","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 : 2023-06-26DOI: 10.30702/ujcvs/23.31(02)/dp027-4549
Oleksandr M. Dovgan, Maksim E. Paulouski, Alona I. Honcharenko, Anton V. Makedon, Y. V. Prystaia
Acute right ventricular failure is a life-threatening condition that can occur as a result of a sudden increase in total pulmonary vascular resistance, in particular, as a result of pulmonary embolism. Most patients with thromboembolism are treated with thrombolytic therapy, but in some cases open thrombextraction is preferred. Removal of blood clots from the pulmonary vascular bed and cardiopulmonary bypass can lead to spasm of the pulmonary artery and to the elevation of total pulmonary resistance, which, in turn, increases the afterload on the right ventricle and can lead to a dramatic decrease in its mechanical function. The aim. The aim of this report is to present the first experience of using the right ventricular bypass with the PROTEKDuo cannula for the purpose of temporary mechanical support of the right ventricle. Case presentation. We studied a 63-year-old patient who underwent Studer technique for bladder adenocarcinoma. On the 14th day an acute massive pulmonary embolism occurred with a drop in hemodynamics and the presence of a floating clot on the right atrium. Thrombolysis carried significant risks due to possible bleeding and clot fragmentation in the right atrium with subsequent embolization of the pulmonary arteries. In these circumstances, open thrombectomy under hypothermic arrest was performed. Intraoperatively, the patient developed acute right ventricular failure resistant to all conservative therapy, therefore, right ventricular bypass was connected using PROTEKDuo, which made it possible to overcome the phenomena of acute right ventricular failure in the postoperative period. Conclusions. Our experience with right ventricular bypass using the PROTEKDuo dual-lumen cannula demonstrates another useful option for saving patients with isolated right ventricular failure.
{"title":"The First Local Experience of Use of Extracorporeal Circulatory Support with PROTEKDuo Dual-Lumen Cannula in a Patient with Acute Right Ventricular Failure","authors":"Oleksandr M. Dovgan, Maksim E. Paulouski, Alona I. Honcharenko, Anton V. Makedon, Y. V. Prystaia","doi":"10.30702/ujcvs/23.31(02)/dp027-4549","DOIUrl":"https://doi.org/10.30702/ujcvs/23.31(02)/dp027-4549","url":null,"abstract":"Acute right ventricular failure is a life-threatening condition that can occur as a result of a sudden increase in total pulmonary vascular resistance, in particular, as a result of pulmonary embolism. Most patients with thromboembolism are treated with thrombolytic therapy, but in some cases open thrombextraction is preferred. Removal of blood clots from the pulmonary vascular bed and cardiopulmonary bypass can lead to spasm of the pulmonary artery and to the elevation of total pulmonary resistance, which, in turn, increases the afterload on the right ventricle and can lead to a dramatic decrease in its mechanical function. \u0000The aim. The aim of this report is to present the first experience of using the right ventricular bypass with the PROTEKDuo cannula for the purpose of temporary mechanical support of the right ventricle. \u0000Case presentation. We studied a 63-year-old patient who underwent Studer technique for bladder adenocarcinoma. On the 14th day an acute massive pulmonary embolism occurred with a drop in hemodynamics and the presence of a floating clot on the right atrium. Thrombolysis carried significant risks due to possible bleeding and clot fragmentation in the right atrium with subsequent embolization of the pulmonary arteries. In these circumstances, open thrombectomy under hypothermic arrest was performed. Intraoperatively, the patient developed acute right ventricular failure resistant to all conservative therapy, therefore, right ventricular bypass was connected using PROTEKDuo, which made it possible to overcome the phenomena of acute right ventricular failure in the postoperative period. \u0000Conclusions. Our experience with right ventricular bypass using the PROTEKDuo dual-lumen cannula demonstrates another useful option for saving patients with isolated right ventricular failure.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45165081","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}
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