Cardiac Surgery and Interventional Cardiology最新文献

{"title":"Performance index – a new approach to the assessment of left ventricular systolic function","authors":"V. I. Pavliuk, О.A. Myshakivsky, M.V. Voytsekhivska, O. Zharinov","doi":"10.31928/2305-3127-2022.1-2.3846","DOIUrl":"https://doi.org/10.31928/2305-3127-2022.1-2.3846","url":null,"abstract":"The aim – to develop a new approach to the assessment of LV systolic function – LV systolic performance index. To check correlation of this index with left ventricular ejection fraction determined by standard Simpson planimetric method.Materials and methods. A total of 121 patients were included into the study. We first determined left ventricular ejection fraction by Simpson method for each patient included in the study, and then determined VTI in the LVOT and myocardial motion velocity in four LV parts. We evaluated the correlation of these indices with left ventricular ejection fraction and derived a hybrid index of LV systolic function performance based on stepwise multiple regression.Results and discussion. The myocardial velocity in four LV parts, its averaged value and velocity time integral in LVOT not only showed a high level of correlation with left ventricular ejection fraction, but appeared also its independent predictors in multivariate analysis. The hybrid formula «0.7 × Sum of MV + VTI» derived in our study provides an index of LV systolic function performance. A good correlation of the new index with left ventricular ejection fraction determined by Simpson (Kendall’s tau 0.818; p <0.00001) was revealed.Conclusions. We proposed a new index of LV systolic function estimation and showed that it allows reliable estimation of LV systolic function in various myocardial pathologies with less time.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78420068","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":"Dreaded coronary artery perforations during percutaneous coronary artery interventions","authors":"H. C. Ramesh, R. Varadaraju, M. Chandrasena, P. Sunil, A. Cherukumudi","doi":"10.31928/2305-3127-2022.1-2.7478","DOIUrl":"https://doi.org/10.31928/2305-3127-2022.1-2.7478","url":null,"abstract":"Spurting coronary artery in the pericardial cavity is observed rarely. Pericardial tamponade occurs and myocardial salvaging time starts ticking. Coronary artery perforations (CAP) have been quoted in literature to range from 0.1 % to 0.7 % of percutaneous coronary artery intervention (PCI) cases. Data was collected retrospectively from the patients of Sri Jayadeva Institute of Cardiovascular Sciences and Research in 2012-2019. A total of 2556 PCI were found in our database of which emergency surgical intervention were needed in 4 patients (0.15 %). Decision making in type 3 CAP with hemodynamic instability is highlighted. Although covered stents and balloons are used to stem the leak, importance of an on call cardiac surgeon cannot be exemplified if the situation is not under control.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87980177","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":"Right ventricular myocardial infarction","authors":"Y. Savitska, A.I. Klantsa, N. Shchepina","doi":"10.31928/2305-3127-2022.1-2.6973","DOIUrl":"https://doi.org/10.31928/2305-3127-2022.1-2.6973","url":null,"abstract":"Right ventricular myocardial infarction is a more common condition than is commonly believed. In the vast majority of cases, it is combined with myocardial infarction of the posterior wall of the left ventricle. However, right ventricular infarction often remains undiagnosed. At the same time, patients with a combination of myocardial infarction of the posterior wall of the left ventricle and the right ventricle have a more unfavorable prognostic course of the disease and require some adjustment of diagnostic and treatment strategies. This article is devoted to the clinical analysis of a case of right ventricular myocardial infarction.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74937280","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":"Determination of the management of a patient with stable ischemic heart disease according to the data of fractional flow reserve study","authors":"M. Stan, A. Khokhlov, О.J. Zharinov, O. Zelenchuk, B. Todurov","doi":"10.31928/2305-3127-2021.3.3943","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.3.3943","url":null,"abstract":"Revascularization of coronary arteries is a key method of the contemporary treatment of patients with atherosclerotic coronary stenoses. However, at an intermediate degree of stenosis, the decision on the appropriateness of revascularization may depend on additional studies of the functional significance of anatomical changes. The study of the fractional flow reserve (FFR) may have a special role in such cases. The publication considers an example of determining the extent of endovascular revascularization in a patient with multivessel lesions of the coronary arteries, with intermediate severity of stenosis. The combination of functional class II angina with unclear result of a stress test, as well as the lack of optimal drug therapy at the time of examination led to the decision to assess physiological significance of all existing stenoses by determining the FFR. Based on the FFR, it was decided to continue monitoring the patient, prescribe optimal medical therapy and refrain from revascularization intervention until the evaluation of its results. Key words: fractional flow reserve, stenting of coronary arteries, revascularization, ischemic heart disease.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74134653","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":"Level of systemic inflammation markers and clinical course in patients with stable ischemic heart disease with and without coronary atherosclerosis","authors":"V. Tseluyko, T. Pylova","doi":"10.31928/2305-3127-2021.3.3138","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.3.3138","url":null,"abstract":"The aim – to investigate the relation between levels of inflammatory factors and clinical course of the ischemic heart disease with and without coronary atherosclerosis. Materials and methods. We examined 105 patients with stable ischemic heart disease (IHD), age 36 to 84 years (mean age 58.5 ± 9.47 years). There were 48.6 % (n = 51) men and 51.4 % (n = 54) women. Based on angiography data, patients were divided into two groups: group I – 53 patients with IHD and non-obstructive coronary arteries (INOCA), group II – 52 patients diagnosed with stable IHD with more than 50 % stenosis. In addition to general clinical methods of examination, the levels of interleukin-6 (IL-6) and highly sensitive C-reactive protein (hsCRP) were determined in all patients. The control group consisted of 20 healthy individuals compared by age and sex. Results. According to the results, it was found that in patients with IHD the level of IL-6 was significantly higher compared to the control, in group I: 4.40 [2.12–9.56] pg/ml and 2.46 [2.29–3.47] pg/ml, respectively (p = 0.027), and in group II – 4.15 [2.80–6.68] pg/ml, which also differed from the control group (p = 0.006). There was no significant difference in the level of IL-6 between groups of patients with IHD depending on the lesion of the coronary arteries (p = 0.99). Among patients with IHD, the level of IL-6 was increased in 40.7 % (n = 22) of patients with INOCA and 34.6 % (n = 18) in patients with stenotic atherosclerosis (group II) (p = 0.22). However, the proportion of women with elevated levels of IL-6 was higher in the INOCA (66.7 %) compared to women with stenotic atherosclerosis (26.7 %) (p = 0.033). Positive correlations were found between the level of IL-6 and the incidence of ventricular arrhythmias in patients of group I (r = 0.44, p = 0.025), as well as between IL-6 and positive cycling stress-test (r = 0.39, p = 0.01), IL-6 and hsCRP (r = 0.43, p = 0.004). According to the results of multivariate regression logistic analysis, an association was established in patients with INOCA between elevated levels of IL-6 and age, hsCRP, history of myocardial infarction and the number of affected vessels (p = 0.04, p = 0.01, p = 0.04, p = 0.037 respectively). Conclusions. Significant differences in the level of IL-6 were found in patients with IHD compared to the control group. It was found that in patients with elevated levels of IL-6, there was higher proportion of women in the INOCA group, compared to the patients with stenotic atherosclerosis. An association was established in patients with INOCA between elevated levels of IL-6 and age, history of myocardial infarction and the number of affected vessels. Key words: ischemic heart disease, INOCA, іnterleukin-6, highly sensitive C-reactive protein.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80028977","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 case of the postinfarction ventricular septum defect successful closure with occluder at the 4th day of the disease","authors":"B. Todurov, М.F. Rotar, А. Khokhlov, К.S. Boiko, Yu.V. Hutsuliak","doi":"10.31928/2305-3127-2021.3.4448","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.3.4448","url":null,"abstract":"The search of effective treatment of myocardial infarction complications remains a relevant issue. Despite the constant improvement of techniques and methods of surgical interventions and the improvement of medical treatment protocols, the mortality due to the postinfarction rupture of the interventricular septum remains quite high. The article presents a clinical case of successful endovascular closure of a postinfarction ventricular septum defect with an occluder with its subsequent surgical closure. The optimal timing of the intervention, the choice of the type of intervention, the optimal medical and hemodynamic support at the stage of preparing the patient for the correction of this complication and in the early postoperative period are described. Our experience shows that the timely use of endovascular techniques to close the defect allows you to create a bridge for open surgery and provide an effective treatment. Key words: myocardial infarction, postinfarction ventricular septum defect, occluder, surgery.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"264 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73471948","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":"Heart rhythm disorders and features of their management at COVID-19 pandemic","authors":"Y. Mostovoy, T. Danilevych","doi":"10.31928/2305-3127-2021.3.515","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.3.515","url":null,"abstract":"Інфекція COVID-19 швидко поширилася по всьому світу та досягнула масштабів пандемії, що призвело до значної захворюваності, напруженості системи охорони здоров’я, збільшення смертності, економічної нестабільності та соціальних проблем. Тяжкий перебіг коронавірусної інфекції досить часто призводить до серцево-судинних ускладнень. Серед них найпоширенішими є міокардит, кардіоміопатії, інфаркт міокарда, тромбоемболії, гостре порушення мозкового кровообігу та порушення серцевого ритму. Механізми виникнення серцево-судинних ускладнень на сьогодні достеменно не відомі. У пацієнтів з уже наявними серцево-судинними захворюваннями та факторами ризику частіше виникають несприятливі наслідки, пов’язані з COVID-2019. Крім того, з’являються дані і про вперше виниклі серцево-судинні ускладнення. Ймовірними механізмами їх виникнення є безпосередня вірусна інвазія кардіоміоцитів, гіпоксія, системна запальна реакція, цитокіновий «шторм» (підвищення рівня феритину, лактатдегідрогенази, С-реактивного білка, інтерлейкіну-6, катехоламінів), ішемія міокарда, дисбаланс електролітів, перевантаження об’ємом, гіперкоагуляція, проаритмогенна побічна дія ліків тощо. Своєю чергою, досить цікавим як з наукової, так і з практичної точки зору є вивчення особливостей поширення та структури аритмій на тлі COVID-19 серед населення України. Крім того, залишаються суперечливими питання щодо особливостей їх ведення, міжлікарської взаємодії, маршрутизації та прогнозу пацієнтів. В огляді відображені останні дані як закордонних, так і вітчизняних науковців щодо поширеності порушень ритму на тлі коронавірусної інфекції та висвітлені основні проблеми ведення таких пацієнтів. Ключові слова: COVID, порушення серцевого ритму, аритмія, фібриляція передсердь, екстрасистолія, блокади, гіпертонічна хвороба, ішемічна хвороба серця, хронічна серцева недостатність","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75577608","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":"Mechanisms and diagnosis of myocardial ischemia in patients with intact coronary arteries","authors":"V. Skybchyk, Yu.P. Melen","doi":"10.31928/2305-3127-2021.3.1624","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.3.1624","url":null,"abstract":"This article describes pathogenetic mechanisms underlying the occurrence of myocardial ischemia and angina attacks in patients without ischemic non-obstructive coronary artery (INOCA) based on coronary angiography. Groups of patients who need additional invasive diagnosis with intracoronary administration of vasoactive agents (adenosine, acetylcholine) were identified. The diagnostic and technical features used during the invasive diagnostic procedure are presented in detail. The main indicators (coronary flow reserve, index of microvascular resistance, hyperemic microvascular resistance) are described. Particular attention is paid to the factors complicating interpretation of the results, as well as to the safety of this procedure. The information obtained during the invasive diagnostic procedure allows to determine the appropriate endotype of INOCA in order to make a correct diagnosis and prescribe effective drug treatment improving prognosis and quality of life. Key words: intact coronary arteries, coronary angiography, invasive diagnostic procedure, vasospastic angina, microvascular angina.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81908854","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 manifestations of coronary artery embolism due to heart tumors","authors":"R. M. Vitovsky, V. V. Isaіenko, O.V. Kupchinsky, I.V. Martyschenko, M. M. Serdyuk","doi":"10.31928/2305-3127-2021.3.2530","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.3.2530","url":null,"abstract":"The aim – to present the features of the clinical manifestations and course of two cases of embolism of the coronary arteries, in which fragments of left atrial (LA) tumors served as the embolic substrate. Materials and methods. This article discusses two cases of embolism with tumor fragments of the coronary arteries. In this case, the neoplasms were located in the left heart. Of particular interest is the fact that the clinical manifestations of embolism varied significantly, from severe pain requiring endovascular intervention, to minor discomfort lasting for several hours, without necessity of the inpatient treatment. Results. It should be noted that in both cases, a tumor lesion of the heart was detected several months after primary manifestation of the disease, namely, embolism of the coronary arteries. Echocardiography study made possible to get a correct diagnosis. In one case it was a routine examination 6 months after stenting of the coronary artery. The reason to perform echocardiography in another case was the result of electrocardiography, showing necrotic changes of the left ventricular posterior wall. In both cases, echocardiographic data prompted immediate surgery of the neoplasms. The structure of neoplasm samples obtained as a result of the surgery confirmed the possibility of coronary artery embolism with tumor fragments. Conclusions. Embolic complications may be a first manifestation of cardiac tumor. Fragmentation of the heart neoplasms may lead to damage of the cerebral and coronary arteries. Embolic complications can occur in young patients. Coronary artery embolism in cardiac tumors is associated with diverse clinical manifestations. Key words: myxoma, heart tumors, embolic complications, coronary arteries, coronary angiography.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90617703","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":"Рerioperative period of high-risk patients with coronary artery disease","authors":"O. Gogayeva","doi":"10.31928/2305-3127-2021.2.2733","DOIUrl":"https://doi.org/10.31928/2305-3127-2021.2.2733","url":null,"abstract":"The aim – to analyze the perioperative period of high-risk patients with coronary artery disease. Materials and methods. 194 patients (age 64.2 ± 8.9 years) with surgery performed, discharged from the specialized clinic within period from 2009 to 2019. All patients underwent laboratory tests, ECG, echocardiography, coronary angiography and coronary artery bypass grafting (CABG). Results. All patients had hemodynamically significant coronary artery stenosis, which required CABG. Acute myocardial infarction at the time of admission was diagnosed in 12 (6.1 %) patients, unstable angina – in 72 (37.1 %) patients. Among comorbid conditions, type 2 diabetes mellitus was diagnosed in 50 (25.7 %) patients, impaired glucose tolerance – in 82 (42.2 %) patients, obesity – in 74 (38.1 %) patients, 86 (44.3 %) patients were overweight with a body mass index 25–29.9 kg/m2, and 75 (38.6 %) patients were diagnosed with chronic kidney disease. According to coronary angiography, the average number of stenosed coronary arteries was 3.5. The risk assessed by EuroSCORE II scale was 7.78 % (from 5.01 % to 68.25 %). Myocardial revascularization was performed on the working heart in 187 (96.3 %) patients, on-pump in 7 (3.6 %) cases. In the postoperative period, 40 (20.6 %) patients developed paroxysmal atrial fibrillations. Acute kidney injury with increase in creatinine by 50 % occurred in 2 (1.03 %) patients. Conclusions. Despite the high predicted mortality (7.78 % by the EuroSCORE II scale) all the patients were discharged on average in 8.4 ± 3.5 days. Careful preoperative diagnosis, preparation, risk stratification, determination of the term of surgery, choice of CABG method taking into account the anthropometric data, the state of the lower extremities veins, anatomical location of coronary arteries, their diameter and degree of damage, personalized drug therapy, allows to achieve good results with minimal complications. Key words: coronary artery disease, high-risk patients, coronary artery bypass grafting, comorbid conditions, off-pump.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86460363","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}