Patologiya krovoobrashcheniya i kardiokhirurgiya最新文献

{"title":"Aortic valve replacement using a polytetrafluoroethylene leaflet valve in patients with a history of the Bentall–De Bono procedure: a case series","authors":"V. Bazylev, A. B. Voevodin, I. D. Potopalskiy, V. A. Karnakhin, M. Patel, A. A. Kuznetsova","doi":"10.21688/1681-3472-2023-1-54-59","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-54-59","url":null,"abstract":"Objective: To analyze outcomes of 4 transcatheter aortic valve replacements using a polytetrafluoroethylene leaflet valve in patients with a history of the Bentall–De Bono procedure.Methods: We retrospectively analyzed a series of 4 cases. From February 2019 to March 2022 in Federal Center for Cardiovascular Surgery (Penza, Russia), patients with a history of the Bentall–De Bono procedure underwent transaortic aortic valve implantation of the MedLAB-CT balloon-expandable valve under cardiopulmonary bypass and cardioplegia. Valve No. 25 was implanted in 3 patients, and 1 patient received valve No. 23.Results: According to echocardiography, valve hemodynamic performance improved in the postoperative period: mean and peak pressure gradients were 11.5 and 24 mm Hg, respectively; the median value of effective orifice area was 1.9 cm2, while mitral regurgitation in all cases did not exceed grade 1. Median cardiopulmonary bypass and myocardial ischemia times were 59 and 31 minutes, respectively. There was no immediate and remote mortality. No complications were reported in the postoperative period.Conclusion: The proposed replacement of the valved conduit’s compromised part after the Bentall–De Bono procedure can significantly reduce the extent of surgery, cardiopulmonary bypass and myocardial ischemia times, as well as simplify the procedure.\u0000Received 1 December 2022. Revised 10 February 2023. Accepted 16 February 2023.\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 interests: The authors declare no conflict of interest.\u0000Contribution of the authorsLiterature review: V.A. Karnakhin, I.D. PotopalskiyDrafting the article: V.V. Bazylev, A.B. Voevodin, I.D. Potopalskiy, V.A. KarnakhinCritical revision of the article: A.A. Kuznetsova, M.P. PatelSurgical treatment: V.V. Bazylev, A.B. VoevodinFinal approval of the version to be published: V.V. Bazylev, A.B. Voevodin, I.D. Potopalskiy, V.A. Karnakhin, M.P. Patel, A.A. Kuznetsova","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76308223","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":"Preoperative and intraoperative risk factors of surgical wound infection in cardiac surgery: a retrospective study","authors":"A. V. Stepin","doi":"10.21688/1681-3472-2023-1-30-37","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-30-37","url":null,"abstract":"Objective: To assess the significance of preoperative and intraoperative risk factors of surgical wound infection in cardiac surgery.Methods: The retrospective study included data obtained from 1,992 medical records of patients after cardiac surgery. All patients were divided into two groups: with (n=97, 4.9%) or without (n=1,895, 95.1%) infectious complications in the postoperative period. The rate of risk factors in both groups was compared and their impact on the surgical wound infection was assessed. Risk factors were analyzed in the groups of patients with superficial and deep forms of infection.Results: In the group of patients with surgical wound infection, males are more common than among the patients without it (82.5% vs. 70.95%). Patients with infection were more likely to have an obesity (43.3% vs. 30.3% without surgical wound infection) and chronic obstructive pulmonary disease (24.7% vs. 13.3%, respectively). In the patients with surgical wound infection, two internal mammary arteries were used more often (29.9% vs. 17.3% without surgical wound infection), the crossover variant of using two internal mammary arteries — 55.2% vs. 34.1% without surgical wound infection. According to the results, male gender and chronic obstructive pulmonary disease increase the risk of surgical wound infection twice as much, with obesity increasing this risk by 1.76 times. Using one of the internal mammary arteries may increase the chances of surgical wound infection by 1.7 times, while using two arteries — by 3.27 times. Increasing the number of factors in one patient may increase the chances of complications by 1.31 times.Conclusion: In cardiac surgery one should assess risk factors of surgical wound infection, plan the surgery (with or without internal mammary arteries), and evaluate the probability of infection complications with personalized approach.\u0000Received 2 February 2022. Revised 20 January 2023. Accepted 16 February 2023.\u0000Funding: The study had no sponsorship.\u0000Conflict of interest: The author declares no conflict of interest.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73150251","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":"Type III endoleaks after endovascular aneurysm repair for abdominal aortic aneurysm: a case series","authors":"E. Kalmykov, I. Suchkov, R. Dammrau","doi":"10.21688/1681-3472-2023-1-67-73","DOIUrl":"https://doi.org/10.21688/1681-3472-2023-1-67-73","url":null,"abstract":"Background: Owing to the increased number of endovascular aneurysm repairs (EVAR) for abdominal aortic aneurysms (AAA), the number of patients requiring reinterventions for type III endoleaks is also growing.Objective: To analyze our experience in treatment of type IIIa and IIIb endoleaks after EVAR.Methods: Of 457 patients treated by EVAR between 2010 and 2019, type IIIa and IIIb endoleaks were detected in 5 (1.1%) patients: 4 men and 1 woman. Their mean age was 67.2 years.Results: Type IIIa and IIIb endoleaks were found in an average of 77.4 months after EVAR. The incidence of type III endoleaks was 1.1%. Type IIIb and IIIa endoleaks were observed in 1 and 4 cases, respectively. In one case, type IIIa endoleak resulted in a ruptured AAA. The main treatment methods were relining (n = 1), stent graft implantation (n = 4), implantation of a bifurcated stent graft into a stent graft. No intraoperative complications or perioperative mortality were reported. 100% of the interventions were successful. In the long-term follow-up period, 2 patients had reinterventions. One patient required an intervention for type IIIa endoleak on the contralateral side, and the other patient was diagnosed with type Ia endoleak after type IIIb endoleak treatment. In the long-term follow-up period, no ruptured aneurysms or deaths were reported.Conclusion: Type III endoleaks are associated with a risk of AAA rupture and require treatment. Endovascular treatment of endoleaks demonstrated good immediate results; however, due to the high risk of endoleaks requiring reintervention, further long-term follow-up is needed.\u0000Received 18 November 2022. Revised 15 December 2022. Accepted 19 December 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 authors: The authors contributed equally to this article.","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":"83123736","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":"Safety of intracoronary iopromide solution for experimental pharmaco-cold ex vivo preservation of donor heart","authors":"M. Zhulkov, D. Sirota, I. Zykov, A. Sabetov, H. Agaeva, A. G. Makaev, D. Osintsev, A.E. Kalendarev, A. P. Nadeev, V. Kliver, A. Tarkova, M. A. Ovchinnikova, A. Fomichev, N. A. Karmadonova, D.V. Khomushku","doi":"10.21688/1681-3472-2022-4-42-51","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-42-51","url":null,"abstract":"Objective: To evaluate the effect of intracoronary iopromide (Ultravist®, Bayer, AG, Leverkusen, Germany) during pharmaco-cold ex vivo preservation of a donor heart on the restoration of heart pumping function and cardiomyocyte metabolism in the early post-transplant period.Methods: Black-and-white calves aged 3 months were used as an experimental model. In the control group, pharmaco-cold preservation of the donor heart was performed by injecting 2 liters of custodiol (Custodiol®, Dr. Franz Köhler Chemie GmbH, Bensheim, Germany) into the aortic root. The hearts were then stored in an appropriate solution at 0 to 1°C for 2 hours. In the experimental group (n = 6), a solution of iopromide and custodiol were injected into the aortic root at a ratio of 50:50 under a pressure of 70-80 mm Hg for 5 minutes after 120 minutes of preservation. Then the coronary bed was washed with 1 liter of custodiol at a pressure of 40 mm Hg and orthotopic heart transplantation was performed. In the post-transplant period, the parameters of central hemodynamics, myocardial oxygen consumption, and the levels of myocardial ischemia markers (troponin I, creatine phosphokinase-MB, lactate dehydrogenase) were assessed.Results: Twelve orthotopic heart transplantations were performed during the study. In 120 minutes after the restoration of spontaneous cardiac activity, the level of cardiac output was 5.11 [4.99; 5.41] L/min and 5.77 [4.97; 6.62] L/min (p = 0.0009) in the control and experimental groups, respectively. Changes in the concentration of lactate dehydrogenase, troponin I and lactate in the blood flowing from the coronary sinus were significantly higher in the early reperfusion period. However, no statistically significant difference was observed between the groups (p > 0.05). Myocardial oxygen consumption was significantly reduced at reperfusion. However, the initial values were restored by reperfusion minute 60 without any significant intergroup difference (p > 0.05).Conclusion: We established the safety of intracoronary iopromide administration for pharmaco-cold ex vivo preservation of the donor heart. Intracoronary administration of iopromide solution does not affect the restoration of the pumping function of the heart or metabolism in cardiomyocytes in the early post-transplant period.\u0000Received 6 May 2022. Revised 14 June 2022. Accepted 11 July 2022.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: Authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, I.S. ZykovData collection and analysis: M.O. Zhulkov, I.S. Zykov, A.K. Sabetov, H.A. Agaeva, A.G. Makaev, D.M. Osintsev, A.E. Kalendarev, A.P. Nadeev, V.E. Kliver, A.R. Tarkova, M.A. Ovchinnikova, N.A. Karmadonova, D.V. KhomushkuStatistical analysis: M.O. Zhulkov, A.G. MakaevDrafting the article: M.O. ZhulkovCritical revision of the article: M.O. Zhulkov, D.A. Sirota, I.S. Zykov, A.V. FomichevFinal approval of the version to be","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"105 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73985094","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":"Gas detection in the portal vein after aortobifemoral bypass: a case report","authors":"M. Zozulya, A. Lenkin, K. M. Lebedinskii","doi":"10.21688/1681-3472-2022-4-73-79","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-73-79","url":null,"abstract":"We present a case report of early surgical treatment of abdominal compartment syndrome after aortobifemoral bypass. A 73-year-old man was admitted to the I.I. Mechnikov North-Western State Medical University with critical lower limb ischemia. Aortobifemoral bypass with a synthetic prosthesis was performed via laparotomy. The postoperative period was complicated by the dynamic bowel obstruction. The patient's condition worsened (hypovolemic and septic shock, respiratory failure due to severe pneumonia). Initial tactics was conservative. Signs of bowel ischemia (pneumatosis of the intestinal wall, gas in the portal vein) were identified using “point of care” ultrasound, which led to a change in the treatment tactics. On the same day, decompression relaparotomy was performed and the intestinal decompression tube was inserted. The postoperative period proceeded with positive dynamics: early extubation with acceptable parameters of gas exchange, minimal dosages of vasopressor support. Bowel function improved and stool appeared on the 2nd day after surgery.Gas in the portal vein is an ultrasound phenomenon, which in 70 % of cases suggests necrosis of the intestinal wall. The detection of such a symptom in patients after the abdominal aorta surgery may indicate bowel ischemia, since mesenteric circulation disorders primarily develop in the inferior mesenteric artery. This condition requires urgent surgical intervention, but its differential diagnosis with postoperative paralytic ileus is not always possible, especially in the early stages. We demonstrate a case of early gas detection in the portal vein and the emergency intervention that allowed preventing irreversible ischemic damage of the bowel. “Point of care” ultrasound can help suspect this condition and determine the indications for early surgical intervention, which can positively influence the outcome.\u0000Received 19 April 2022. Revised 29 May 2022. Accepted 1 June 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 authors: The authors contributed equally to this article.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73674588","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":"Long-term outcomes of drug-eluting balloons for treatment of side branches in patients with true coronary bifurcation lesions","authors":"T. K. Eraliev, D. Khelimskii, A. Badoian, O. Krestyaninov, A. A. Baranov, A. Gorgulko","doi":"10.21688/1681-3472-2022-4-7-18","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-7-18","url":null,"abstract":"Background: Bifurcation treatments make up ca. 15–20% of coronary interventions. Despite the use of drug-eluting stents, the management of bifurcation lesions, especially with side branches involved, remains a challenge.Objective: To evaluate long-term clinical and angiographic outcomes after using a paclitaxel-coated balloon for the treatment of side branches in patients with true bifurcation lesions.Methods: Eighty patients with coronary artery disease were enrolled after true bifurcation lesion stenting. All patients were randomized at the 1:1 ratio to the group of main branches stenting followed by the dilatation of side branches with drug-eluting balloons and provisional stenting group.Results: Long-term results were analyzed after 12 months. The most common bifurcation lesion involved the left anterior descending artery and diagonal branch (57.5%). Late lumen loss in the side branch (0.51 ± 0.22 vs 0.33 ± 0.24 mm) and in both the bifurcation branches (main branch + side branch) (1.06 ± 0.29 vs 0.79 ± 0.27 mm) was significantly higher in the patients after provisional stenting.Overall postoperative incidence of major adverse cardiovascular events was 17.5% and 7.5% (p = 0.31) in the provisional stenting and drug coated balloon groups, respectively. Patients with drug-eluting balloons for the treatment of side branches had a more pronounced decrease in angina symptoms after 12 months. Multivariate analysis showed that diabetes mellitus (OR: 10.9) and glomerular filtration rate (OR: 0.95) were independent predictors of major adverse cardiovascular events in bifurcation interventions.Conclusion: Drug-eluting balloons for the dilatation of side branches after the stenting of main branches are superior to provisional stenting in terms of the late lumen loss.\u0000Received 31 August 2022. Revised 17 November 2022. Accepted 18 November 2022.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: The authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. KrestyaninovData collection and analysis: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov, A.A. Baranov, A.P. GorgulkoStatistical analysis: T.K. Eraliev, D.A. Khelimskii, A.G. BadoianDrafting the article: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov, A.A. Baranov, A.P. GorgulkoCritical revision of the article: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. KrestyaninovFinal approval of the version to be published: T.K. Eraliev, D.A. Khelimskii, A.G. Badoian, O.V. Krestyaninov, A.A. Baranov, A.P. Gorgulko","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85704541","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":"Surgical treatment of distal aneurysms on superior cerebellar artery: two case reports","authors":"A. Somova, I. Senko, K. Orlov","doi":"10.21688/1681-3472-2022-4-67-72","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-67-72","url":null,"abstract":"Distal aneurysms of the superior cerebellar arteries (SCA) present a rare subgroup of intracranial aneurysms. Only few case reports describe this condition. Therefore, the surgical approach to treating distal SCA aneurysms remains controversial.We are demonstrating surgical treatments of previously unavailable, distal SCA aneurysms as a number of multimodal case reports.We describe two different ways to treat two patients with distal SCA aneurysms and provide a literature review. First, a 38-year-old patient presented with an acute subarachnoid ventricular hemorrhage due to distal SCA aneurysm rupture. Microsurgical clipping of the aneurysm was performed. Then the aneurysm ruptured intraoperatively, which required temporary clipping of the SCA trunk. The postoperative period was complicated by a progressive and eventually lethal cerebral angiospasm. Another, 36-year-old female patient was admitted in acute condition after recurrent ruptures of a distal SCA aneurysm associated with subarachnoid parenchymal hemorrhage. The patient underwent endovascular SCA deconstruction at the aneurysm level. No complications or neurological symptoms were observed postoperatively. The patient was discharged for outpatient treatment on day 4.Endovascular surgery should be considered as a method of choice for ruptured distal SCA aneurysms. Microsurgical intervention may be an option when endovascular repair is impossible and when other surgical procedures such as removal of hematoma and prevention of occlusive hydrocephalus are required.\u0000Received 31 August 2022. Revised 14 November 2022. Accepted 18 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: Authors declare no conflict of interest.\u0000Contribution of the authors: The authors contributed equally to this article.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"113 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87937031","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":"Aortic stenting for aortic isthmus stenosis caused by the patent ductus arteriosus occluder: a case report","authors":"R. Tarasov, A.Yu. Kolesnikov, I. Vereshchagin","doi":"10.21688/1681-3472-2022-4-60-66","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-60-66","url":null,"abstract":"We present a case report of stenting the aortic isthmus to manage a rare complication – stenosis caused by the patent ductus arteriosus occlude previously implanted to a child at the age of 7 months. After 7 years the patient was re-admitted to the cardiology hospital with the signs and symptoms of the aortic coarctation. The echocardiography revealed a peak pressure gradient of 40 mm Hg in the area of the aortic isthmus. The pressure gradient between the upper and lower extremities was 25-30 mm Hg. At the age of 8 the compromised blood flow in the aorta was completely resolved by stenting the aortic isthmus with covering of the implanted occluder. Andrastent XL (Andramed GmbH, Reutlingen, Germany) stent was implanted. Characteristics of this stent allow expanding it up to 14 mm. The pressure gradient in the area of the aortic isthmus was completely eliminated after the procedure. The effectiveness of the intervention was confirmed after 7 months with echocardiography. In conclusion, the aortic stenting using devices with the potential for further expansion as the child grows is justified due to its effectiveness, minimal invasiveness, and radical nature.\u0000Received 5 March 2022. Revised 10 July 2022. Accepted 11 July 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 authors: The authors contributed equally to this article.","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73432628","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":"Endovascular treatment of multilevel brachiocephalic artery lesions in asymptomatic patients: a case series","authors":"A. Vanyurkin, A. Soboleva, N. Susanin, Yu. K. Belova, V. Soloviev, M. Chernyavskiy","doi":"10.21688/1681-3472-2022-4-52-59","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-52-59","url":null,"abstract":"Objective: To evaluate the outcomes of complete endovascular carotid revascularization in asymptomatic patients with tandem lesions of common carotid arteries (CCA) and internal carotid arteries (ICA) and to demonstrate the endovascular technique.Methods: Endovascular treatment of two-level brachiocephalic artery lesions was performed in 23 patients at the Almazov National Medical Research Centre from 2017 to 2022. The mean age of the patients was 71.3 years. The lesions were localized in the left CCA and ICA in 11 patients, in the right CCA and ICA in 7 patients, and in the brachiocephalic trunk and right ICA in 5 patients. All patients were asymptomatic on the affected side. Results: Completed with successful stent implantation, all the procedures were effective, with no complications at the access site (hematoma, dissection, bleeding) and no perioperative mortality or residual stenoses. Postoperative neurological disorders developed in two patients including ipsilateral neurological symptoms (NIHSS score 4, Rankin score 1) in one of them and moderate aphasia and dysarthria NIHSS score 2, Rankin score 1) in the other. Brain MSCT showed signs of ischemic stroke that did not require any additional surgical treatment in the second patient. Following the rehabilitation, the neurological symptoms regressed. The mean hospital stay was 4 days. Two years after the intervention two patients required reintervention, i.e. repeat angioplasty of the ICA stent, due to in-stent restenosis.Conclusion: The outcomes in a series of patients with tandem brachiocephalic artery lesions indicate the efficacy of complete endovascular intervention with good short-term results.\u0000Received 23 June 2022. Revised 31 July 2022. Accepted 23 August 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 interests: Authors declare no conflict of interest.\u0000Contribution of the authorsLiterature review: A.V. Soboleva, V.A. SolovievDrafting the article: A.G. Vanyurkin, Yu.K. BelovaCritical revision of the article: M.A. ChernyavskiySurgical treatment: M.A. Chernyavskiy, A.G. Vanyurkin, N.V. SusaninFinal approval of the version to be published: A.G. Vanyurkin, A.V. Soboleva, N.V. Susanin, Yu.K. Belova, V.A. Soloviev, M.A. Chernyavskiy","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"1 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72373807","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":"Combined method of renal denervation in an animal model","authors":"D. Bashta, L. I. Vilenskiy, Y. Krivosheev, A. Simonyan, A. Romanov","doi":"10.21688/1681-3472-2022-4-33-41","DOIUrl":"https://doi.org/10.21688/1681-3472-2022-4-33-41","url":null,"abstract":"Background: Currently, intra-arterial radiofrequency renal denervation is an only interventional treatment for resistant hypertension. However, available data are controversial since this method does not provide the long-term hypotensive effect.Objective: To compare the safety and efficacy of laparoscopic mechanical renal denervation and laparoscopic combined renal denervation using a radiofrequency clamp.Methods: Thirty sheep weighing 93.00 ± 3.72 kg were divided into two groups for mechanical laparoscopic renal denervation (group I, n = 15) and combined laparoscopic renal denervation with a radiofrequency clamp (group II, n = 15). The observation period lasted for six months. We assessed the following parameters: blood pressure (BP) in response to high-frequency electric stimulation from the lumen of the vessel, creatinine and uric acid levels, iatrogenic damage to the renal arteries based on angiography findings, and destruction of nerve fibers based on histological findings.Results: All the animals survived throughout the observation period. Creatinine and uric acid levels were within the normal ranges. Renal angiography did not reveal any iatrogenic stenosis. After six months, we found some BP response (elevated systolic BP ∆66.73 ± 6.63 mm Hg [p < 0.001], elevated diastolic BP ∆47.27 ± 5.98 mm Hg [p < 0.001]) to high-frequency electric stimulation in group I and no hypertensive response in group II. After six months, the animals were withdrawn for further histological assessment. Histology revealed complete destruction of the nerve fiber (demyelination) in group II and vacuolized swollen nerve fibers without any signs of demyelination in group I.Conclusion: Laparoscopic combined renal denervation is a safe and efficacious method with a stable hypotensive effect after six months in an animal model as compared to laparoscopic mechanical renal denervation.\u0000Received 30 March 2022. Revised 5 December 2022. Accepted 9 December 2022.\u0000Funding: The study did not have sponsorship.\u0000Conflict of interest: Authors declare no conflict of interest.\u0000Contribution of the authorsConception and study design: D.I. Bashta, L.I. Vilenskiy, A.B. RomanovData collection and analysis: D.I. Bashta, Yu.S. Krivosheev, A.A. SimonyanStatistical analysis: D.I. Bashta, Yu.S. KrivosheevDrafting the article: D.I. Bashta, Yu.S. Krivosheev Critical revision of the article: L.I. Vilenskiy, Yu.S. Krivosheev, A.B. Romanov Final approval of the version to be published: D.I. Bashta, L.I. Vilenskiy, Yu.S. Krivosheev, A.A. Simonyan, A.B. Romanov","PeriodicalId":19853,"journal":{"name":"Patologiya krovoobrashcheniya i kardiokhirurgiya","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87539306","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}