1
|
Stryukova EV, Shramko VS, Kashtanova EV, Polonskaya YV, Stakhneva EM, Kurguzov AV, Chernyavskiy AM, Ragino YI. Cytokine Profile and Concentrations of Metabolic Hormones in the Blood of Overweight Men with Coronary Arteriosclerosis. Bull Exp Biol Med 2023:10.1007/s10517-023-05817-y. [PMID: 37335447 DOI: 10.1007/s10517-023-05817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Indexed: 06/21/2023]
Abstract
Plasma concentrations of cytokines and metabolic hormones and their association with vulnerable atherosclerotic plaques were studied in 36 overweight men (age 40-77 years; BMI 25.0-29.9 kg/m2) with coronary atherosclerosis who underwent coronary endarterectomy. According to histological analysis, the patients were divided into two groups: with stable (17 (47.2%) men) and vulnerable (19 (52.8%) men) plaques in the coronary arteries. The plasma levels of cytokines and metabolic hormones were measured by multiplex analysis: C-peptide, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1, glucagon, IL-6, insulin, leptin, monocyte chemoattractant protein-1, and TNFα. In overweight patients with vulnerable plaques, the level of glucagon was lower by 4.17 times, GIP - by 2.47 times, and insulin - by 2.1 times. At the same time, the risk of occurrence of a vulnerable plaque increases by 5.4% with a decrease in GIP concentration by 1 pg/ml irrespectively of age, as well as by 3.1% with an increase in insulin concentration by 10 pg/ml, without achieving statistical significance when included in the age model. Overweight men with coronary atherosclerosis and vulnerable plaques have lower levels of insulin, glucagon, and GIP. The levels of GIP and insulin are inversely associated with the risk of having vulnerable atherosclerotic plaque.
Collapse
Affiliation(s)
- E V Stryukova
- Research Institute of Therapy and Preventive Medicine - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia.
| | - V S Shramko
- Research Institute of Therapy and Preventive Medicine - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - E V Kashtanova
- Research Institute of Therapy and Preventive Medicine - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Ya V Polonskaya
- Research Institute of Therapy and Preventive Medicine - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - E M Stakhneva
- Research Institute of Therapy and Preventive Medicine - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A V Kurguzov
- E. N. Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - A M Chernyavskiy
- E. N. Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - Yu I Ragino
- Research Institute of Therapy and Preventive Medicine - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| |
Collapse
|
2
|
Kamenskaya OV, Klinkova AS, Loginova IY, Porotnikova SS, Habarov DV, Lomivorotov VN, Lomivorotov VV, Chernyavskiy AM. [Impairment of cognitive functions in patients with chronic thromboembolic pulmonary hypertension before and after surgical treatment]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:126-131. [PMID: 36843469 DOI: 10.17116/jnevro2023123021126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE To study cognitive functions in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and in the long-term after pulmonary thromboendarterectomy and to study factors that negatively affect cognitive status. MATERIAL AND METHODS One hundred and twenty-four patients with CTEPH were examined before and 6 months after surgery with an assessment of cognitive impairment using the Mini-Mental State Examination (MMSE). Multivariate regression analysis was used to identify factors affecting the MMSE indicators before and in the long-term postoperative periods. RESULTS Initially, patients with CTEPH had a total MMSE score 23.8±1.1. Six months after surgery, the score was 26.1±1.9 (p<0.001). A history of stroke, disability, stress (loss of spouse), and a high Charleson comorbidity index were independent factors affecting MMSE score before surgery. After surgery, the total MMSE score was influenced by a history of stroke, stress (loss of spouse), residual pulmonary hypertension and atrial fibrillation in the early postoperative period. CONCLUSION Cognitive impairment in the form of mild dementia was observed in patients with CTEPH before surgery. Six months after the operation, an improvement in cognitive status was revealed, which corresponded to moderate cognitive impairment. At the same time, no complete recovery of cognitive functions was recorded. Patients with CTEPH still experienced the greatest difficulties in the following areas: concentration and counting, memory. A history of stroke, disability, stress (loss of spouse), and a high comorbidity index are associated with a decrease in MMSE scores before surgery. Six months after surgery, MMSE score was affected by a history of stroke, stress (loss of spouse), residual pulmonary hypertension and atrial fibrillation in the early postoperative period.
Collapse
Affiliation(s)
- O V Kamenskaya
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - A S Klinkova
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - I Y Loginova
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - S S Porotnikova
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - D V Habarov
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia.,Research Institute of Clinical and Experimental Lymphology - Branch of Institute of Cytology and Genetics, Novosibirsk, Russia
| | - V N Lomivorotov
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - V V Lomivorotov
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - A M Chernyavskiy
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia
| |
Collapse
|
3
|
Shadanov AA, Sirota DA, Lyashenko MM, Kobelev E, Khomushku DOV, Chernyavskiy AM. [Hybrid treatment of Kommerell diverticulum and giant aneurysm of intra-thoracic segment of aberrant left subclavian artery]. Khirurgiia (Mosk) 2023:90-93. [PMID: 36800875 DOI: 10.17116/hirurgia202303190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Kommerell's diverticulum causes compression of the esophagus, trachea and laryngeal nerve between the aberrant mouth of the left subclavian artery and ascending aorta. This leads to dysphagia or shortness of breath. We describe hybrid treatment of the right aortic arch with Kommerell's diverticulum and giant aneurysm of the aberrant left subclavian artery.
Collapse
Affiliation(s)
- A A Shadanov
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - D A Sirota
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - M M Lyashenko
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - E Kobelev
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - D-O V Khomushku
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | | |
Collapse
|
4
|
Chazova IE, Martynyuk TV, Gorbachevskii SV, Gramovich VV, Danilov NM, Panchenko EP, Chernyavskiy AM, Shmalts AA, Yavelov IS. ["Guiding lights" for the diagnosis of chronic thromboembolic pulmonary hypertension in the flow of patients with pulmonary embolism]. TERAPEVT ARKH 2022; 94:1052-1056. [PMID: 36286754 DOI: 10.26442/00403660.2022.09.201836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
On December 13, 2021, an expert council was held to determine the position of experts of different specialties regarding the reasons for the low level of diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in real clinical practice in a pandemic of a new coronavirus infection and possible ways to improve detection in patients with pulmonary embolism (PE) ) in history. The reasons for the low level of diagnosis of CTEPH are the insufficient level of knowledge of specialists, especially primary care physicians; lack of clear regulatory documents and expert centers for the management of this category of patients. Primary diagnosis of CTEPH in a pandemic can be strengthened through the widespread use of telemedicine for consultations of primary care physicians with specialists from expert centers; to maximize the role of echocardiography and computed tomography (CT) as differential diagnostic tools for dyspnea, in particular in patients with COVID-19. To increase the detection rate of CTEPH, diagnostic vigilance is required in patients with risk factors and episodes of venous thromboembolism. To improve the screening of CTEPH, it is necessary to create an algorithm for monitoring patients who have had PE; provide educational activities, including through the media; create materials for patients with accessible information. The regulatory documents should designate the circle of responsible specialists who will be engaged in long-term monitoring of patients with PE. Educational programs are needed for primary care physicians, cardiologists, and other physicians who come into the field of view of patients with CTEPH; introduction of a program to create expert centers for monitoring and managing patients with the possibility of performing ventilation-perfusion lung scintigraphy, cardiopulmonary stress test, CT, right heart catheterization. It seems important to build cooperation with the Ministry of Health of Russia in order to create special protocols, procedures for managing patients with PE and CTEPH.
Collapse
Affiliation(s)
- I E Chazova
- Chazov National Medical Research Center of Cardiology
| | - T V Martynyuk
- Chazov National Medical Research Center of Cardiology
- The Russian National Research Medical University named after N.I. Pirogov
| | - S V Gorbachevskii
- Bakoulev Scientific Center for Cardiovascular Surgery
- Russian Medical Academy of Continuous Professional Education
| | - V V Gramovich
- Chazov National Medical Research Center of Cardiology
| | - N M Danilov
- Chazov National Medical Research Center of Cardiology
| | - E P Panchenko
- Chazov National Medical Research Center of Cardiology
| | | | - A A Shmalts
- Bakoulev Scientific Center for Cardiovascular Surgery
- Russian Medical Academy of Continuous Professional Education
| | - I S Yavelov
- National Medical Research Center for Therapy and Preventive Medicine
| |
Collapse
|
5
|
Kamenskaya OV, Klinkova AS, Loginova IY, Lomivorotov VN, Chernyavskiy AM, Lomivorotov VV. Single-center register of myocardial revascularization in patients with coronary artery disease and acute coronary syndrome in the context of COVID-19 pandemic. Cardiovasc Ther Prev 2021. [DOI: 10.15829/1728-8800-2021-2876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim. To assess the short- and long-term outcomes of myocardial re- vascularization (MR) in patients with coronary artery disease (CAD) and acute coronary syndrome (ACS) in the context of coronavirus disease 2019 (COVID-19) pandemic.Material and methods. In the period from April to August 2020, 550 patients with CAD and ACS were included in the register. Emergency percutaneous transluminal coronary angioplasty (n=499) and on-pump coronary artery bypass grafting (CABG) (n=51) were performed. The follow-up period lasted 6 months. The pattern of complications after MR and effects of COVID-19 were analyzed.Results. The studied cohort is represented by patients with CAD >65 years old. ST segment elevation ACS was detected in 23%, acute myocardial infarction — in 59,1%, in other cases — unstable angina. During hospitalization after MR, atrial fibrillation prevailed among cardiovascular complications (4,7%). During this period, 29 (5,3%) patients was diagnosed with COVID-19. In the short-term period after MR, 3 (0,5%) people died due to COVID-19 complications-. In the long-term period after MR, 4 (0,7%) cases of non-fatal stroke were registered, while repeated MR — in 7,1%. The all-cause mortality rate was 1,3% (n=7), of which 57,1% of patients died due to COVID-19 complications. In the subgroup of patients who underwent CABG, the greatest number of in-hospital complications was noted, where exudative pleurisy, atrial fibrillation and anemia prevailed. Of the patients with COVID-19, pneumonia in the short-and long-term posto perative periods was recorded in 48,3 and 61,3%, respectively. Pneumonia is associated with respiratory failure, cardiac dysfunction, and anemia. The risk of COVID-19 pneumonia during the entire follow-up period was higher in patients with ACS who underwent CABG (odds ratio, 19,4; confidence interval: 13,3-26,1; p<0,001). The overall survival rate was 98,7%.Conclusion. COVID-19 infection in patients with ACS after MR effects pattern of postoperative complications. The proportion of COVID-19 pneumonia in patients with ACS in hospital, short- and long-term postoperative periods after MR significantly exceeds that in the general population. The leading factor associated with COVID-19 pneumonia in patients with ACS is on-pump CABG.
Collapse
Affiliation(s)
| | | | | | | | | | - V. V. Lomivorotov
- Meshalkin National Medical Research Center; Novosibirsk National Research State University
| |
Collapse
|
6
|
Zhuravleva IY, Timchenko TP, Vladimirov SV, Lyashenko MM, Kuznetsova EV, Chernyavskiy AM. Ab ovo: Factors Affecting the Radial Stiffness of Thoracic Aorta Stent-Grafts. Sovrem Tekhnologii Med 2021; 13:17-25. [PMID: 34513062 PMCID: PMC8353689 DOI: 10.17691/stm2021.13.1.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Indexed: 11/14/2022] Open
Abstract
The aim of the investigation was to study the factors influencing the radial stiffness of the thoracic aorta stent-grafts with the stent elements made of nitinol tubes by laser cutting and thermal shape setting.
Collapse
Affiliation(s)
- I Yu Zhuravleva
- Professor, Head of the Laboratory of Bioprostheses; Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 15 Rechkunovskaya St., Novosibirsk, 630055, Russia
| | - T P Timchenko
- Junior Researcher, Laboratory of Bioprostheses; Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 15 Rechkunovskaya St., Novosibirsk, 630055, Russia
| | - S V Vladimirov
- Engineer, Laboratory of Bioprostheses; Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 15 Rechkunovskaya St., Novosibirsk, 630055, Russia
| | - M M Lyashenko
- Acting Head, Department of the Aorta and Coronary Arteries; Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 15 Rechkunovskaya St., Novosibirsk, 630055, Russia
| | - E V Kuznetsova
- Research Assistant, Laboratory of Bioprostheses; Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 15 Rechkunovskaya St., Novosibirsk, 630055, Russia
| | - A M Chernyavskiy
- Professor, Director, Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, 15 Rechkunovskaya St., Novosibirsk, 630055, Russia
| |
Collapse
|
7
|
Grenadyorov AS, Zhulkov MO, Solovyev АА, Oskomov KV, Semenov VA, Chernyavskiy AM, Sirota DA, Karmadonova NA, Malashchenko VV, Litvinova LS, Khaziakhmatova OG, Gazatova ND, Khlusov IA. Surface characterization and biological assessment of corrosion-resistant a-C:H:SiO x PACVD coating for Ti-6Al-4V alloy. Mater Sci Eng C Mater Biol Appl 2021; 123:112002. [PMID: 33812622 DOI: 10.1016/j.msec.2021.112002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/05/2021] [Accepted: 02/22/2021] [Indexed: 01/08/2023]
Abstract
The paper focuses on the SiOx-doped amorphous hydrocarbon (a-C:H:SiOx) coating on the titanium (Ti-6Al-4V) alloy substrate obtained by plasma-assisted chemical vapor deposition (PACVD) in a mixture of argon gas and polyphenylmethylsiloxane vapor using a bipolar substrate bias. It is shown that the a-C:H:SiOx coating deposition results in the formation of a negative surface potential important for application of this coating for medical implants. The a-C:H:SiOx coatings improve the corrosion resistance of Ti alloy to 0.5 M NaCl solution and phosphate-buffered saline. In particular, the corrosion current density of the a-C:H:SiOx-coated sample in a 0.5 M NaCl solution at 22 °C decreases from 1∙10-8 to 1.7∙10-10 A/cm2, that reduces the corrosion rate from 9∙10-5 to 15∙10-7 mm/year. The a-C:H:SiOx coating facilitates the surface endothelization of an implant located in the thoracic aorta of a mini pig, and reduces the risk of thrombosis and implant failure. This effect can be explained by the ability of the a-C:H:SiOx coating ability to reduce in vitro a 24-hour secretion of pro-inflammatory interleukins (IL-6, IL-12(p70), IL-15, and IL-17) and cytokines (IFN-g and TNF-a) by blood mononuclear cells (MNCs) and elevates the concentration of anti-inflammatory interleukin IL-1Ra. In vitro analysis shows no cytotoxicity of the a-C:H:SiOx coating for the human blood MNCs, suggesting a promising PACVD on Ti alloys for cardiovascular implants, including pumps for mechanical heart support systems.
Collapse
Affiliation(s)
- A S Grenadyorov
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia
| | - M O Zhulkov
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia; Meshalkin National Medical Research Center, 15, Rechkunovskaya Str., 630055 Novosibirsk, Russia
| | - А А Solovyev
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia.
| | - K V Oskomov
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia
| | - V A Semenov
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia
| | - A M Chernyavskiy
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia; Meshalkin National Medical Research Center, 15, Rechkunovskaya Str., 630055 Novosibirsk, Russia
| | - D A Sirota
- Meshalkin National Medical Research Center, 15, Rechkunovskaya Str., 630055 Novosibirsk, Russia
| | - N A Karmadonova
- Meshalkin National Medical Research Center, 15, Rechkunovskaya Str., 630055 Novosibirsk, Russia
| | - V V Malashchenko
- The Institute of High Current Electronics SB RAS, 2/3, Akademichesky Ave., 634055 Tomsk, Russia; Immanuel Kant Baltic Federal University, 14A, Nevskii Str., 236041 Kaliningrad, Russia
| | - L S Litvinova
- Immanuel Kant Baltic Federal University, 14A, Nevskii Str., 236041 Kaliningrad, Russia
| | - O G Khaziakhmatova
- Immanuel Kant Baltic Federal University, 14A, Nevskii Str., 236041 Kaliningrad, Russia
| | - N D Gazatova
- Immanuel Kant Baltic Federal University, 14A, Nevskii Str., 236041 Kaliningrad, Russia
| | - I A Khlusov
- Immanuel Kant Baltic Federal University, 14A, Nevskii Str., 236041 Kaliningrad, Russia; Siberian State Medical University, 2, Moskovskii Tract, 634050 Tomsk, Russia; National Research Tomsk Polytechnic University, 30, Lenin Ave., 634050 Tomsk, Russia
| |
Collapse
|
8
|
Kamenskaya OV, Klinkova AS, Lomivorotov VV, Shmyrev VA, Chernyavskiy AM. [Predictors of neurological complications after cardiac surgical interventions in oldery patients.]. Adv Gerontol 2020; 33:319-324. [PMID: 32593247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To identify predictors of neurological complications in the hospital period after coronary artery bypass grafting (CABG), 92 patients with coronary heart disease aged 70 years and over were analyzed. Intraoperative monitoring of cerebral oxygenation (rSO2, %) was carried out. At the stage of induction anesthesia, the average level of rSO2 for left and right hemispheres was 64-65% without significant changes during the operation. A decrease in rSO2 during cardiopulmonary bypass (CPB) was associated with increased risk of neurological complications. The risk of neurological complications increase 7-fold and 9-fold with a decrease in rSO2 by 20% or more during CPB relative to baseline for left and right hemispheres, respectively. A history of two or more myocardial infarctions increases 3-fold the risk of neurological complications after CABG.
Collapse
Affiliation(s)
- O V Kamenskaya
- E.N.Meshalkin National Medical Research Center, 15 Rechkunovskaya str., Novosibirsk 630055, Russian Federation, e-mail:
| | - A S Klinkova
- E.N.Meshalkin National Medical Research Center, 15 Rechkunovskaya str., Novosibirsk 630055, Russian Federation, e-mail:
| | - V V Lomivorotov
- E.N.Meshalkin National Medical Research Center, 15 Rechkunovskaya str., Novosibirsk 630055, Russian Federation, e-mail:
| | - V A Shmyrev
- E.N.Meshalkin National Medical Research Center, 15 Rechkunovskaya str., Novosibirsk 630055, Russian Federation, e-mail:
| | - A M Chernyavskiy
- E.N.Meshalkin National Medical Research Center, 15 Rechkunovskaya str., Novosibirsk 630055, Russian Federation, e-mail:
| |
Collapse
|
9
|
Novikova N, Chernyavskiy AM, Romanov AB, Grankin DS, Edemskiy AG, Pokushalov EA. P2776Radiofrequent pulmonary artery denervation - alternative treatment of residual chronic thromboembolic pulmonary hypertension. Results of a randomized pilot study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Pulmonary endarterectomy (PEA) is the gold standard of CTEPH treatment. However, residual CTEPH develops in 10–40% of patients after PEA, which leads to progression of right ventricular insufficiency. Currently, the only way to treat residual CTEPH is PAH-specific drug therapy. However, this treatment is not indicated for all patients because of the arterial hypotension and dyspeptic disorders.
Purpose
To assess the safety and efficacy of radiofrequent pulmonary artery denervation (PADN) in patients with residual CTEPH after PEA.
Methods
In 2015, a randomized pilot study was conducted to evaluate PADN in patients with residual CTEPH (NCT 02745106). 278 patients with CTEPH after PEA were screened. In 62 of them, according to the echocardiography, residual CTEPH (systolic pulmonary artery pressure (PAP) ≥45 mm Hg) was detected. In 50 patients, residual CTEPH was confirmed during right heart catheterization (RHC): mean PAP ≥25 mmHg and pulmonary vascular resistance (PVR) >400 dyn s cm–5. Patients were randomized into two groups: 25 in PADN group and 25 in drug therapy group with riociguat. Mean age was 39 years [26; 51]. The mean duration after PEA was 4.5 years [1; 8.5]. The primary end point was PVR in the short-term and long-term follow-up. Secondary end points were: mean PAP, cardiac output, 6-minute walk test (6MWD) and NYHA functional class. All patients were followed up for 12 months after discharge. The PADN procedure was performed using electrophysiological catheter Navistar RMT Thermocool, Biosense Webster, Diamond Bar, CA, USA and non-fluroscopic 3D navigation system.
Results
There was no mortality. In two patients (one in each group) hematoma developed in femoral vein puncture site without any consequences. The mean surgery time was 105 [93; 120] minutes. After 12 months, PVR was significantly lower in the PADN group compared with the drug treatment group (343±149 dyn s cm–5 vs 444±145 dyn s cm–5, respectively; mean difference −101, 95% confidence interval from −193 to −10; p=0.032). The mean PAP was also significantly lower in the PADN group (25.8±7.3 mm Hg vs. 33.8±6.4 mm Hg, p<0.001). We noticed a significant improvement of 6MWD test in PADN group compared with the drug treatment group (470±84 m versus 399±116 m, respectively, p=0.031). In PADN group 1 (4%) patient was hospitalized due to progression of heart failure compared with 7 patients (29%) in the drug treatment group (p=0.049). One patient (4%) in the PADN group and two patients (8%) in the drug treatment group died due to progression of heart failure over the long-term follow-up.
Conclusions
The PADN technique showed its safety and efficacy in the treatment of patients with residual CTEPH and can be used in clinical practice. The obtained first results showed that the proposed PADN, together with optimal medical therapy, can take a place in the treatment of residual CTEPH after PEA.
Collapse
Affiliation(s)
- N Novikova
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - A M Chernyavskiy
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - A B Romanov
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - D S Grankin
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - A G Edemskiy
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - E A Pokushalov
- State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| |
Collapse
|
10
|
Chernyavskiy AM, Lyashenko MM, Tarkova AR, Sirota DA, Khvan DS, Kretov EI, Prokhorikhin AA, Malaev DU, Boykov AA. [Hybrid procedures for aortic arch disease]. Khirurgiia (Mosk) 2019:87-93. [PMID: 31120454 DOI: 10.17116/hirurgia201904187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Different surgical approaches for aortic arch disease were reviewed in the article. We have also compared various vascular prostheses for aortic replacement.
Collapse
Affiliation(s)
- A M Chernyavskiy
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - M M Lyashenko
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - A R Tarkova
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - D A Sirota
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - D S Khvan
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - E I Kretov
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - A A Prokhorikhin
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - D U Malaev
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| | - A A Boykov
- Meshalkin National medical research center of Ministry of Health of the Russia, Novosibirsk, Russia
| |
Collapse
|
11
|
Alsov SA, Osipov DE, Akchurin RS, Shiryaev AA, Sirota DA, Khvan DS, Chernyavskiy AM, Tsirikhov VR. [Microsurgery of coronary arteries using an operating microscope]. Khirurgiia (Mosk) 2019:60-64. [PMID: 30789610 DOI: 10.17116/hirurgia201901160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The world experience of coronary artery bypass surgery using an operating microscope is reviewed in the article. Important role of operating microscope and microsurgical techniques for coronary anastomoses formation is shown. High optical magnification provided by operating microscope directly affects the quality of surgical technique and accuracy of coronary anastomoses suturing that affects postoperative graft patency. Thus, the use of operating microscope can affect the results of coronary artery bypass surgery, as shown in several reports.
Collapse
Affiliation(s)
- S A Alsov
- Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia
| | - D E Osipov
- Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia
| | - R S Akchurin
- National Medical Research Center of Cardiology of Healthcare Ministry of the Russian Federation, Moscow, Russia
| | - A A Shiryaev
- National Medical Research Center of Cardiology of Healthcare Ministry of the Russian Federation, Moscow, Russia
| | - D A Sirota
- Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia
| | - D S Khvan
- Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia
| | - A M Chernyavskiy
- Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia
| | - V R Tsirikhov
- Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia, National Medical Research Center of Cardiology of Healthcare Ministry of the Russian Federation, Moscow, Russia
| |
Collapse
|
12
|
Chernyavskiy AM, Edemskiy AG, Novikova NV, Romanov AB, Artemenko SN, Rudenko BA, Tarkova AR. Radiofrequency Pulmonary Artery Ablation for Treatment of Residual Pulmonary Hypertension After Pulmonary Endarterectomy. Kardiologiia 2018; 58:15-21. [PMID: 30704379 DOI: 10.18087/cardio.2018.4.10105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE to assess the safety and efficiency of radiofrequency pulmonary artery ablation for treatment of residual pulmonary hypertension after pulmonary endarterectomy. MATERIAL AND METHODS Radiofrequency pulmonary artery denervation (PADN) was performed in 16 patients (10 men, mean age 39 years [26; 51]). Indication for PADN was mean pulmonary artery pressure (PAP) >25 mm Hg with absence of proximal pulmonary artery lesion according to computer tomography. PADN procedure was performed with nonfluoroscopic 3D navigation system. RESULTS After PADN mean PAP decreased from 37.3 mm Hg [29; 38] to 24.6 mm Hg [17; 30] (p=0.01); pulmonary vascular resistance decreased from 672 dyn∙s∙c-5 [387; 566] to 386 dyn∙s∙c-5 [155; 449] (р=0.02); cardiac output increased from 3.4 l/min [3.2; 3.4] to 3.5 l/ min [3.2; 4.0] (p=0.4); 6-minute walk test distance increased from 427 meters [352; 510] to 447 meters [370; 525] (p=0.16), respectively. CONCLUSION Initial results allow to assume that radiofrequency pulmonary artery denervation combined with optimal medical therapy may take its rightful place in the treatment of this category of patients.
Collapse
Affiliation(s)
- A M Chernyavskiy
- ФГБУ «Национальный медицинский исследовательский центр им. акад. Е. Н. Мешалкина» Минздрава России.
| | | | | | | | | | | | | |
Collapse
|
13
|
Kamenskaya OV, Loginova IY, Klinkova AS, Chernyavskiy AM, Alsov SA, Sirota DA, Lomivorotov VV, Karaskov AM. [Predictors of neurological complications during surgical treatment of the ascending aorta and aortic arch chronic dissection]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:12-17. [PMID: 30132450 DOI: 10.17116/jnevro20181187112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To evaluate the prognostic significance of oxygen supply to the brain in the risk of neurological complications in the early post operative period of surgical treatment of the ascending aorta and aortic arch. MATERIAL AND METHODS The level of oxygenation (rSO2) in the right and left hemispheres was measured in 68 patients with ascending aorta and aortic arch chronic dissection. Before and in the nearest period after surgery, the patients underwent a clinical/instrumental neurological study. RESULTS The incidence of ischemic stroke in the early post operative period was 5.9%, cognitive impairment was recorded in 22% of patients. Among the parameters of oxygen supply to the brain, the dynamics of rSO2 during circulatory arrest had a significant impact on the post operative neurological status. The risk of cognitive impairment, besides the association with the oxygen status of the brain, increased with the age of patients and comorbid pathology. CONCLUSION The decrease in rSO2 by ≥30% during surgical treatment of ascending aorta and aortic arch dissection increases the risk of ischemic stroke and cognitive impairment in the early post operative period.
Collapse
Affiliation(s)
- O V Kamenskaya
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - I Yu Loginova
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - A S Klinkova
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - A M Chernyavskiy
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - S A Alsov
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - D A Sirota
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - V V Lomivorotov
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - A M Karaskov
- Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
| |
Collapse
|
14
|
Abstract
Aim:to show the analysis of 10-year heart transplantation experience, the main complications and problems of the heart transplantation evaluation. Materials and methods.66 orthotopic heart transplantations were performed in patients with terminal chronic heart failure in our clinic since 2008. The heart failure causes were dilated cardiomyopathy in 46 cases (70%), postinfarction cardiosclerosis in 20 cases (30%). The recipients were 59 men (89%) and 7 women (11%), the average age was 46 ± 10 years. All patients had a severe left heart dilatation and critical left ventricular systolic dysfunction (left ventricular EDV 283 ± 58 ml, left ventricular ejection fraction 17 ± 5%, cardiac index 1.5 ± 0.3 l/min/m2). In some recipients, heart transplantation is performed in the second stage after preliminary implantation of mechanical circulatory support systems (LVAD, BVAD). The fi rst heart transplantations were performed using the biatrial technique (8 cases (12%)), the others were performed using the bicaval technique (58 cases (88%)). After the operation, patients received a three-component immunosuppressive therapy: the inhibitors of calcineurin, mycophenolate and corticosteroids.Results.54 patients (82%) were discharged from the clinic after heart transplantation. The hospital mortality was 12 recipients (18%). The mortality in the long-term period was 10 recipients (15%). The hospital mortality cases were acute graft dysfunction in 5 cases (42%), infectious-septic complications in 4 cases (33%), massive intraoperative bleeding in 2 cases (17%), and total thrombosis of pulmonary artery in 1 case (8%). The death causes in the long-term period were acute transplant rejection in 4 cases (40%), coronary artery disease of the transplanted heart in 3 cases (30%), Kaposi’s sarcoma in 1 case (10%), lung cancer in 1 case (10%), and viral pneumonia in 1 case (10%).Conclusion.Over a 10-year period, we have gained a lot of experience in heart transplantation; the procedures complications have been studied; the stages of preservation, harvesting and transportation of the donor heart, operative technique and postoperative treatment of patients have been improved to avoid complications in the early and long-term postoperative period.
Collapse
Affiliation(s)
- A. M. Chernyavskiy
- Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
| | - D. V. Doronin
- Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
| | - A. V. Fomichev
- Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
| | - D. E. Osipov
- Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
| | - V. A. Shmyrev
- Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
| | - A. M. Karaskov
- Meshalkin National Medical Research Center, Ministry of Health of Russian Federation
| |
Collapse
|
15
|
Chernyavskiy AM, Edemskiy AG, Chernyavskiy MA, Efimenko VG, Tarkova AR, Ivanov SN. [Efficiency of Operation Trombendarterektomy From Pulmonary Artery Branches Depending on the Degree of Pulmonary Hypertension and Duration of Disease]. Kardiologiia 2017; 56:56-59. [PMID: 28294875 DOI: 10.18565/cardio.2016.5.56-59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM to assess effect of thromboendarterectomy from pulmonary artery branches on clinical functional state of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in dependence on degree of pulmonary hypertension and disease duration. MATERIAL Patients (n=152) were divided into 3 groups: (1) with systolic pulmonary artery pressure (SPAP) less or equal 50 mm Hg (n=20), (2) with SPAP>50- less or equal 80mm Hg (n=46), (3) with SPAP >80mm Hg (n=86). METHODS Examination included registration of dynamics of general clinical state and character of complaints, six-minute walk test, transthoracic echocardiography with measurement of SPAP and right ventricular ejection fraction, pulmonary perfusion scintigraphy with calculation of index of perfusion deficit. RESULTS AND CONCLUSION Pulmonary thromboendarterectomy from pulmonary artery branches was associated with stable improvement of clinical functional state of patients with CTEPH and regression of symptoms irrespective of preoperative level of pulmonary hypertension.
Collapse
Affiliation(s)
- A M Chernyavskiy
- Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulaton Pathology, Novosibirsk, Russia
| | - A G Edemskiy
- Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulaton Pathology, Novosibirsk, Russia
| | - M A Chernyavskiy
- Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulaton Pathology, Novosibirsk, Russia
| | - V G Efimenko
- Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulaton Pathology, Novosibirsk, Russia
| | - A R Tarkova
- Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulaton Pathology, Novosibirsk, Russia
| | - S N Ivanov
- Academician E.N. Meshalkin Novosibirsk State Research Institute of Circulaton Pathology, Novosibirsk, Russia
| |
Collapse
|
16
|
Tarkova AR, Chernyavskiy AM, Grigor’Ev IA, Morozov SV, Rodionov VI, Kravchenko NI. EFFICACY OF DIFFERENT FORMS OF LOCAL HEMOSTATIC MATERIALS BASED ON OXIDIZE CELLULOSE IN THE EXPERIMENT. VESTNIK KHIRURGII IMENI I I GREKOVA 2015. [DOI: 10.24884/0042-4625-2015-174-6-56-59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- A. R. Tarkova
- E. N. Meshalkin Novosibirsk Research Institute of Pathology of Blood Circulation
| | - A. M. Chernyavskiy
- E. N. Meshalkin Novosibirsk Research Institute of Pathology of Blood Circulation
| | - I. A. Grigor’Ev
- E. N. Meshalkin Novosibirsk Research Institute of Pathology of Blood Circulation
| | - S. V. Morozov
- N. N. Vorozhtsov Novosibirsk Institute of Organic Chemistry
| | - V. I. Rodionov
- N. N. Vorozhtsov Novosibirsk Institute of Organic Chemistry
| | - N. I. Kravchenko
- E. N. Meshalkin Novosibirsk Research Institute of Pathology of Blood Circulation
| |
Collapse
|
17
|
Chernyavskiy AM, Alsov SA, Lyashenko MM, Sirota DA, Khvan DS. Change of descending aortic false lumen after repair of type I dissection by De Bakey. Patol krovoobrashch kardiokhir 2015. [DOI: 10.21688/1681-3472-2013-2-29-34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Group of authors analyzes the state of thoracoabdominal aorta after reconstruction of ascending and arch of aorta. Currently, there is no single point of view on the amount of interference in the ascending part and the aortic arch in preventing complications of thoracoabdominal aorta. In a group of 46 patients the authors by means of issuing a series of multislice computed tomography, performed at different times after surgery and examine the status thoracoabdominal aorta at different levels. Based on the results of the study revealed that, under the first phase of the surgery department at the ascending aorta and arch over her bundle for DeBakey type I, there is no need to take in a false lumen in the descending thoracic aorta, as it not only does not reduce or slow dilation thoracoabdominal aorta in the long-term, but it is a more rapid increase in comparison with patients with a false lumen was. Saving or suturing the false lumen does not affect the incidence of thrombosis in late postoperative period, and therefore, closure of a false channel in the first phase of intervention is inappropriate.
Collapse
|
18
|
Chernyavskiy AM, Chernyavskiy MA, Vinogradova TY, Yedemskiy AG. Hybrid technologies in surgical treatment of patients with concomitant atherosclerotic lesions of carotid and coronary arteries. Patol krovoobrashch kardiokhir 2015. [DOI: 10.21688/1681-3472-2013-1-45-53] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cardiovascular diseases, which have their origins in atherosclerosis, are the "leaders" in morbidity and mortality among the population in many countries. Given the increase of elderly people in the population, it is important to choose the best strategy for surgical treatment of patients with combined atherosclerotic lesions of several arteries (coronary arteries, carotid arteries, peripheral arteries of the lower extremities, atherosclerosis visceral branches of the abdominal aorta). Currently, there is yet no common approach to the timing and sequence of revascularization surgery in this group of patients. The rapid development of endovascular techniques enables us to carry out the so-called hybrid procedures in patients with atherosclerotic lesions of several arteries. In this article we analyze different strategies that are used to manage patients with both coronary and carotid arteries atherosclerotic lesions.
Collapse
|
19
|
Ragino YI, Chernyavskiy AM, Tsimbal SY, Shcherbakova LV, Polonskaya YV, Kashtanova EV. Relationship of blood levels of inflammatory and destructive biomarkers in coronary atherosclerosis with long-term results of surgical revascularization. Bull Exp Biol Med 2015; 155:314-7. [PMID: 24137592 DOI: 10.1007/s10517-013-2142-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The relationships between blood levels of inflammatory and destructive biomarkers (TNF-α, IL-1β, IL-6, IL-8, soluble CD40 ligand, high-sensitivity C-reactive protein, endothelial adhesion molecules, matrix metalloproteinase 3 and 9 and their tissue inhibitor type 1) were studied in men with coronary atherosclerosis before and 5 years after coronary artery bypass surgery. In men with unfavorable course of coronary atherosclerosis in the delayed period, the initial blood levels of C-reactive protein and TNF-α by 1.7 and 3.0 times surpassed those in patients with favorable course of the disease. Associations were revealed between elevated blood content of high-sensitivity C-reactive protein (p=0.01, odds ratio of 1.33) and IL-8 (p=0.02, odds ratio of 1.02) and deaths in the delayed period; IL-6 (p=0.01, odds ratio of 1.02) and cases of myocardial infarction; C-reactive protein (p=0.02, odds ratio of 1.24) and unfavorable course of the delayed period in general (death, myocardial infarction, worsening of angina pectoris functional class).
Collapse
Affiliation(s)
- Yu I Ragino
- Institute of Therapy, Siberian Division of Russian Academy of Medical Sciences, Novosibirsk; E. N. Meshalkin Research Institute of Circulatory Pathology, Ministry of Health and Social Development of the Russian Federation, Novosibirsk, Russia.
| | | | | | | | | | | |
Collapse
|
20
|
Tarkova AR, Chernyavskiy AM, Grigor'ev IA, Morozov SV, Rodionov VI, Kravchenko NI. [EFFICACY OF DIFFERENT FORMS OF LOCAL HEMOSTATIC MATERIALS BASED ON OXIDIZE CELLULOSE IN THE EXPERIMENT]. Vestn Khir Im I I Grek 2015; 174:56-59. [PMID: 27066660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The bleeding of intraoperative period is one of the actual problem in surgery. There aren't any universal hemostatic means in spite of large variety of modern hemostatic methods. An experimental research studied the results of hemostatic activity of different forms of materials on the basis of oxidize cellulose (a gauze, a powder) as compared with their foreign analog (a hemostatic gauze "SurgiceI"). Median of hemostasis time consisted of (120 ± 59.9) and (73 ± 46.8) s, in case of application of gauze and powder preparations, respectively. The rate of group using the hemostatic gauze "Surgicel" was (142 ± 77.4) s. The authors made a conclusion on the basis of given research, that the hemostatic material based on oxidize cellulose (the powder form) showed a more expressed hemostatic activity and reliably twice reduced the time of hemostasis as compared with their analog forms of gauze (p < 0.05).
Collapse
|
21
|
Akhmedov SD, Krivoschekov EV, Pekarskaya MV, Krylov AL, Vesnina ZV, Chernov VI, Chernyavskiy AM, Vechersky YY, Karpov RS, Nechaev EA. Clinical results of dynamic cardiomyoplasty. J Card Surg 1995; 10:573-9. [PMID: 7488781 DOI: 10.1111/j.1540-8191.1995.tb00635.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Thirty-five cardiomyoplasty procedures were performed in five patients with dilated and 30 patients with ischemic cardiomyopathies. Russian-made cardiomyostimulators (CMS) were implanted in these patients. Twenty-one patients underwent a one-step procedure using a left thoracotomy for cardiomyoplasty, while in 14 patients, a two-step procedure that included a mid-line sternotomy was carried out. During the average follow-up period of 9 +/- 2.1 months, studies were carried out that showed in survivors improved clinical functional status and decreased heart failure symptoms. Evidence of revascularization of the ischemic myocardium from the latissimus dorsi muscle (LDM) wrap was obtained by angiography and radioactive scintigraphy. In five patients, the CMS had to be removed due to complications, and in all these patients, their clinical functional status deteriorated following the cessation of cardiomyostimulation.
Collapse
Affiliation(s)
- S D Akhmedov
- Department of Cardiothoracic Surgery, Institute of Cardiology, Tomsk, Russia
| | | | | | | | | | | | | | | | | | | |
Collapse
|