Infective endocarditis in patients after COVID-19 has a more severe course. Cardiovascular pathology and pathophysiological changes in other organs and systems due to COVID-19 should be considered. We present a clinical case of successful cardiosurgical treatment of a patient with multiple heart valve pathology due to infective endocarditis associated with COVID-19 and coronary artery disease.
{"title":"Successful perioperative management of infective endocarditis in a patient after COVID-19","authors":"I.Yu. Mokryk, N.V. Malova, I.O. Stetsiuk, G.F. Hassanzadeh","doi":"10.31928/2305-3127-2023.3-4.3437","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.3437","url":null,"abstract":"Infective endocarditis in patients after COVID-19 has a more severe course. Cardiovascular pathology and pathophysiological changes in other organs and systems due to COVID-19 should be considered. We present a clinical case of successful cardiosurgical treatment of a patient with multiple heart valve pathology due to infective endocarditis associated with COVID-19 and coronary artery disease.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.31928/2305-3127-2023.3-4.515
M.B. Todurov, O. Zelenchuk, A. V. Khokhlov, M. Stan, N.O. Yashchenko
The aim – to conduct a literature review, analyze and, based on our own results, present an algorithm for choosing the tactics of surgical treatment of patients with severe aortic stenosis.Materials and methods. In this prospective study, the medical records of adult patients (from 18 years of age) who underwent surgical or transcatheter aortic valve replacement at the Heart Institute of the Ministry of Health of Ukraine, between 2018 and 2023 were analyzed.Results. The algorithm for the selection of surgical treatment of patients included in the study was built based on a thorough analysis of the anamnesis, clinical, laboratory and instrumental examination data. An important stage in choosing the optimal surgical tactics is the assessment of the development of intraoperative and postoperative complications according to the EuroSCORE and STS SCORE scales, which are most widely used in cardiac surgery practice and allow predicting the complicated course of the early postoperative period in patients with acquired valvular heart defects. Although there is an increasing trend towards TAVI in younger, lower-risk patients, the more frequent possibility of residual paravalvular insufficiency and the need for permanent pacemaker implantation should be considered. As the experience of interventional cardiologists increases and new valve designs and delivery systems are developed, better clinical outcomes and lower complication rates can be expected, which will contribute to the expansion of indications for TAVI.Conclusions. Today, TAVI remains the only way to correct aortic valve defects for inoperable patients with severe symptomatic aortic stenosis. Based on the results of several randomized controlled trials, TAVI is associated with a much lower rate of postoperative complications and a faster recovery, and should be the method of choice in all high surgical risk patients and a competitive alternative to aortic valve replacement in intermediate risk patients.
{"title":"Patient selection criteria for transcatheter implantation of aortic valve","authors":"M.B. Todurov, O. Zelenchuk, A. V. Khokhlov, M. Stan, N.O. Yashchenko","doi":"10.31928/2305-3127-2023.3-4.515","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.515","url":null,"abstract":"The aim – to conduct a literature review, analyze and, based on our own results, present an algorithm for choosing the tactics of surgical treatment of patients with severe aortic stenosis.Materials and methods. In this prospective study, the medical records of adult patients (from 18 years of age) who underwent surgical or transcatheter aortic valve replacement at the Heart Institute of the Ministry of Health of Ukraine, between 2018 and 2023 were analyzed.Results. The algorithm for the selection of surgical treatment of patients included in the study was built based on a thorough analysis of the anamnesis, clinical, laboratory and instrumental examination data. An important stage in choosing the optimal surgical tactics is the assessment of the development of intraoperative and postoperative complications according to the EuroSCORE and STS SCORE scales, which are most widely used in cardiac surgery practice and allow predicting the complicated course of the early postoperative period in patients with acquired valvular heart defects. Although there is an increasing trend towards TAVI in younger, lower-risk patients, the more frequent possibility of residual paravalvular insufficiency and the need for permanent pacemaker implantation should be considered. As the experience of interventional cardiologists increases and new valve designs and delivery systems are developed, better clinical outcomes and lower complication rates can be expected, which will contribute to the expansion of indications for TAVI.Conclusions. Today, TAVI remains the only way to correct aortic valve defects for inoperable patients with severe symptomatic aortic stenosis. Based on the results of several randomized controlled trials, TAVI is associated with a much lower rate of postoperative complications and a faster recovery, and should be the method of choice in all high surgical risk patients and a competitive alternative to aortic valve replacement in intermediate risk patients.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"100 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139444427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.31928/2305-3127-2023.3-4.2329
O. Zelenchuk, B. Todurov, I.O. Stetsiuk, V. Demyanchuk, D. Loskutov, N.O. Yashchenko, N. V. Ponych
The aim – comparison of the results of David and Bentall operations in patients with aneurysms of the root and ascending aorta. Materials and methods. The one-centre study included 85 patients who underwent planned and urgent surgical treatment from 2019 to 2022. The patients were divided into two groups depending on the type of surgical intervention: the Bentall procedure was performed in the I group, while the David procedure was performed in the II group. Results. The study did not determine statistically significant differences in such indicators as the duration of artificial blood circulation and the time of aortic clamping. No significant differences were found in the duration of artificial lung ventilation and stay in the intensive care unit. However, the total length of hospital stay in the group of patients with David procedure was statistically lower and was 17.3 (8–35) days, while in the group with Bentall operation it was 23.7 (10–40) days (p = 0.01). The results of our analysis show that the early postoperative clinical results of the David and Bentall procedures are good and there are no significant differences. During David procedure, a statistically significant positive result of surgical treatment was revealed by such an indicator as the degree of insufficiency on the aortic valve (before and after the operation, 2.7 ± 1.3 and 0.8 ± 0.6, respectively, p < 0.05). In addition to the above indicator, significant results were found in the indicators: left ventricular end-diastolic size and left ventricular end-diastolic volume. Conclusions. The good immediate results of Bentall and David operations suggest that surgical repair of ascending and aortic root aneurysms using these operations can be equally safe when performed according to absolute anatomical indications and by an experienced surgical team. If both operations might be used in a particular patient, the valve-sparing operation should be preferred, given the lower risk of postoperative complications associated with the presence of a mechanical or biological prosthesis (such as thromboembolism, bleeding associated with anticoagulants, and structural deterioration of the bioprosthesis).
{"title":"The effectiveness of David procedure for aneurysm of the root and ascending part of the aorta","authors":"O. Zelenchuk, B. Todurov, I.O. Stetsiuk, V. Demyanchuk, D. Loskutov, N.O. Yashchenko, N. V. Ponych","doi":"10.31928/2305-3127-2023.3-4.2329","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.2329","url":null,"abstract":"The aim – comparison of the results of David and Bentall operations in patients with aneurysms of the root and ascending aorta. Materials and methods. The one-centre study included 85 patients who underwent planned and urgent surgical treatment from 2019 to 2022. The patients were divided into two groups depending on the type of surgical intervention: the Bentall procedure was performed in the I group, while the David procedure was performed in the II group. Results. The study did not determine statistically significant differences in such indicators as the duration of artificial blood circulation and the time of aortic clamping. No significant differences were found in the duration of artificial lung ventilation and stay in the intensive care unit. However, the total length of hospital stay in the group of patients with David procedure was statistically lower and was 17.3 (8–35) days, while in the group with Bentall operation it was 23.7 (10–40) days (p = 0.01). The results of our analysis show that the early postoperative clinical results of the David and Bentall procedures are good and there are no significant differences. During David procedure, a statistically significant positive result of surgical treatment was revealed by such an indicator as the degree of insufficiency on the aortic valve (before and after the operation, 2.7 ± 1.3 and 0.8 ± 0.6, respectively, p < 0.05). In addition to the above indicator, significant results were found in the indicators: left ventricular end-diastolic size and left ventricular end-diastolic volume. Conclusions. The good immediate results of Bentall and David operations suggest that surgical repair of ascending and aortic root aneurysms using these operations can be equally safe when performed according to absolute anatomical indications and by an experienced surgical team. If both operations might be used in a particular patient, the valve-sparing operation should be preferred, given the lower risk of postoperative complications associated with the presence of a mechanical or biological prosthesis (such as thromboembolism, bleeding associated with anticoagulants, and structural deterioration of the bioprosthesis).","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"55 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139441768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.31928/2305-3127-2023.3-4.1622
V. Bogomaz, I. Berdnyk, L. Lysa
The aim – to evaluate the possibilities of long-term patch monitoring of the electrocardiogram (ECG) to determine gender and age characteristics of the frequency of detection of atrial fibrillation (AF). Materials and methods. A total of 1,123 patients participated in this 2-year (2021–2023) retrospective multicenter study. Long-term ECG monitoring was performed at the referral of internists and cardiologists of 30 health care institutions according to various clinical indications for this study. For long-term monitoring of the ECG, the innovative device «Mawi Heart Patch» was used – a disposable two-channel device with the possibility of continuous recording of the ECG for up to 7 days. The primary analysis of the records was carried out using Cardio.ai artificial intelligence algorithms, re-decryption and validation by certified doctors. Results. The average age of the study participants was (50.2 ± 16.65) years. There were 599 (53.3 %) women, 524 (46.6 %) men. The average time of ECG monitoring was (81.03 ± 18.5) hours, 74.35 % of the participants had continuous ECG monitoring for 3 days, 20.75 % for 4 days, and 2.58 % for 5 days. In total, AF was diagnosed in 7.93 % of patients, in particular, women and men were 6.51 % and 9.54 % respectively (p > 0.05). In elderly patients, AF was diagnosed statistically significantly more often than in middle-aged patients (18.5 and 3.6 %, respectively, p ˂ 0.001). Among all age groups, the highest frequency of detection of AF was in participants over 75 years old, compared to young (28.8 % vs 3.6 %, p ˂ 0.001) and middle-aged patients (28.8 vs 18.5 %, p ˂ 0.05). Conclusions. The study did not reveal a gender difference in the frequency of diagnosing AF. In patients over 50 years, a significant increase in the frequency of detection of AF was recorded, which tends to increase in the following age periods and reaches a maximum in long-livers (over 90 years). The use of long-term patch ECG monitoring in patients of older age groups expands diagnostic possibilities and makes it possible to prevent complications in time.
{"title":"Gender and age characteristics and atrial fibrillation during long-term telemonitoring of the ECG","authors":"V. Bogomaz, I. Berdnyk, L. Lysa","doi":"10.31928/2305-3127-2023.3-4.1622","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.1622","url":null,"abstract":"The aim – to evaluate the possibilities of long-term patch monitoring of the electrocardiogram (ECG) to determine gender and age characteristics of the frequency of detection of atrial fibrillation (AF). Materials and methods. A total of 1,123 patients participated in this 2-year (2021–2023) retrospective multicenter study. Long-term ECG monitoring was performed at the referral of internists and cardiologists of 30 health care institutions according to various clinical indications for this study. For long-term monitoring of the ECG, the innovative device «Mawi Heart Patch» was used – a disposable two-channel device with the possibility of continuous recording of the ECG for up to 7 days. The primary analysis of the records was carried out using Cardio.ai artificial intelligence algorithms, re-decryption and validation by certified doctors. Results. The average age of the study participants was (50.2 ± 16.65) years. There were 599 (53.3 %) women, 524 (46.6 %) men. The average time of ECG monitoring was (81.03 ± 18.5) hours, 74.35 % of the participants had continuous ECG monitoring for 3 days, 20.75 % for 4 days, and 2.58 % for 5 days. In total, AF was diagnosed in 7.93 % of patients, in particular, women and men were 6.51 % and 9.54 % respectively (p > 0.05). In elderly patients, AF was diagnosed statistically significantly more often than in middle-aged patients (18.5 and 3.6 %, respectively, p ˂ 0.001). Among all age groups, the highest frequency of detection of AF was in participants over 75 years old, compared to young (28.8 % vs 3.6 %, p ˂ 0.001) and middle-aged patients (28.8 vs 18.5 %, p ˂ 0.05). Conclusions. The study did not reveal a gender difference in the frequency of diagnosing AF. In patients over 50 years, a significant increase in the frequency of detection of AF was recorded, which tends to increase in the following age periods and reaches a maximum in long-livers (over 90 years). The use of long-term patch ECG monitoring in patients of older age groups expands diagnostic possibilities and makes it possible to prevent complications in time.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"121 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139444377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.31928/2305-3127-2023.3-4.4452
O. Onyshchenko, D. Riabenko, O.A. Yepanchintseva
The article describes a clinical case of a combination of myocarditis and hereditary dilated cardiomyopathy. In a 40-year-old man cardiomegaly and HF, which occurred for the first time, were initially associated with an inflammatory process in the myocardium. Further genetic examinations showed that pathological processes in the myocardium are also associated with a pathogenic mutation in the FLNC gene and a mutation in the TNT gene. The myocarditis that developed on the background of family (hereditary) dilated cardiomyopathy. However, despite the positive effect of the treatment of myocarditis and contemporary drug therapy, the progression of the pathological process in the myocardium was noted. This clinical case emphasizes the importance of a complete diagnostic examination with the use of genetic testing in certain cases.
{"title":"Dilated cardiomyopathy and myocarditis: a clinical case","authors":"O. Onyshchenko, D. Riabenko, O.A. Yepanchintseva","doi":"10.31928/2305-3127-2023.3-4.4452","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.4452","url":null,"abstract":"The article describes a clinical case of a combination of myocarditis and hereditary dilated cardiomyopathy. In a 40-year-old man cardiomegaly and HF, which occurred for the first time, were initially associated with an inflammatory process in the myocardium. Further genetic examinations showed that pathological processes in the myocardium are also associated with a pathogenic mutation in the FLNC gene and a mutation in the TNT gene. The myocarditis that developed on the background of family (hereditary) dilated cardiomyopathy. However, despite the positive effect of the treatment of myocarditis and contemporary drug therapy, the progression of the pathological process in the myocardium was noted. This clinical case emphasizes the importance of a complete diagnostic examination with the use of genetic testing in certain cases.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.31928/2305-3127-2023.3-4.5363
M. Satyr, I. Noverko, T.I. Pantus, M.S. Zagriichuk
Renal transplantation is a replacement-based therapeutic method in end-stage kidney failure.It is based on the interdisciplinary collaboration between scientists and clinicians, which match together the achievements of surgery, immunology, and radiation diagnostics. After transplantation the complications appear, which can be associated with status of the graft, the immunological factors of compatibility between the donor and the recipient, the surgical intervention. Early diagnosis and forehanded treatment of such complications is important, as it helps to evaluate and predict the functionality of the graft. In this article we discuss the complications after kidney transplantation: the reasons of their occurrence, pathogenesis, clinical features, and radiation imaging signs. The opportunities of the radiology methods for the differential diagnostics of complications which appear before, during or after the surgery, are shown. We pay the main attention to the nuclear medicine methods, especially the dynamic renal scintigraphy (DRSG) as a method for the evaluation of graft functionality. This is a safe, accessible and non-invasive method for evaluation the quantitative and qualitative parameters of kidney function. DRSG consequently characterizes the perfusion, the extraction and the excretion in the studied organ. We display the standard DRSG protocols using [99mTc] Tc-MAG3 and [99mTc] Tc-DTPA radiopharmaceuticals. We analyze investigations of kinetic perfusion and parenchymal DRSG parameters and their importance for differential diagnosis of complications, prognosis on delayed and slow graft function, short-term and long-term graft functionality assessment. We make an accent on the prognostic importance of the dynamic changes visible on DRSG. We discuss the perspectives of further development of scintigraphic methods for the assessment of kidney grafts. It is related to the implementation of high-quality 3-dimentional visualization, newest radiopharmaceuticals. We conclude the importance of the nuclear medicine as an element of multidisciplinary approach in transplantology.
{"title":"Significance of nuclear medicine methods for diagnosis and predicting the course of renal transplantation complications","authors":"M. Satyr, I. Noverko, T.I. Pantus, M.S. Zagriichuk","doi":"10.31928/2305-3127-2023.3-4.5363","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.5363","url":null,"abstract":"Renal transplantation is a replacement-based therapeutic method in end-stage kidney failure.It is based on the interdisciplinary collaboration between scientists and clinicians, which match together the achievements of surgery, immunology, and radiation diagnostics. After transplantation the complications appear, which can be associated with status of the graft, the immunological factors of compatibility between the donor and the recipient, the surgical intervention. Early diagnosis and forehanded treatment of such complications is important, as it helps to evaluate and predict the functionality of the graft. In this article we discuss the complications after kidney transplantation: the reasons of their occurrence, pathogenesis, clinical features, and radiation imaging signs. The opportunities of the radiology methods for the differential diagnostics of complications which appear before, during or after the surgery, are shown. We pay the main attention to the nuclear medicine methods, especially the dynamic renal scintigraphy (DRSG) as a method for the evaluation of graft functionality. This is a safe, accessible and non-invasive method for evaluation the quantitative and qualitative parameters of kidney function. DRSG consequently characterizes the perfusion, the extraction and the excretion in the studied organ. We display the standard DRSG protocols using [99mTc] Tc-MAG3 and [99mTc] Tc-DTPA radiopharmaceuticals. We analyze investigations of kinetic perfusion and parenchymal DRSG parameters and their importance for differential diagnosis of complications, prognosis on delayed and slow graft function, short-term and long-term graft functionality assessment. We make an accent on the prognostic importance of the dynamic changes visible on DRSG. We discuss the perspectives of further development of scintigraphic methods for the assessment of kidney grafts. It is related to the implementation of high-quality 3-dimentional visualization, newest radiopharmaceuticals. We conclude the importance of the nuclear medicine as an element of multidisciplinary approach in transplantology.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"55 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139442164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.31928/2305-3127-2023.3-4.3033
V.G. Karpenko, V. Vashkeba, V. Sakalov, I.V. Galamai, M.D. Glagola, K.S. Boiko, V. Demyanchuk
Anomalous left coronary artery from the pulmonary artery is a rare congenital pathology of the coronary arteries, which is associated with 90 % mortality during the first year of life, therefore it requires a detailed diagnosis and surgical intervention from the first days of the patient's life. The presence of additional congenital anomalies is a factor increasing the risk of surgery. We present a clinical case and successful hybrid approach for correction of anomalous course of the left coronary artery from the right pulmonary artery in combination with coarctation of the aorta in the newborn.
{"title":"Successful repair of the anomalous left coronary artery from the right pulmonary artery associated with aortic coarctation in the newborn","authors":"V.G. Karpenko, V. Vashkeba, V. Sakalov, I.V. Galamai, M.D. Glagola, K.S. Boiko, V. Demyanchuk","doi":"10.31928/2305-3127-2023.3-4.3033","DOIUrl":"https://doi.org/10.31928/2305-3127-2023.3-4.3033","url":null,"abstract":"Anomalous left coronary artery from the pulmonary artery is a rare congenital pathology of the coronary arteries, which is associated with 90 % mortality during the first year of life, therefore it requires a detailed diagnosis and surgical intervention from the first days of the patient's life. The presence of additional congenital anomalies is a factor increasing the risk of surgery. We present a clinical case and successful hybrid approach for correction of anomalous course of the left coronary artery from the right pulmonary artery in combination with coarctation of the aorta in the newborn.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"71 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139445029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-16DOI: 10.31928/2305-3127-2022.3-4.5561
R. M. Vitovskyi, V. V. Isaіenko, T. I. Dedkova, O. Pishchurin, V. Zakharova, A.D. Kipioro
The article presents a case of a truly infected heart myxoma in a 25-year-old patient. His main complaint during hospitalization was a daily increase in body temperature for 8 months up to 39 °C. Resection of the tumor was performed. During the surgery, a tumor typical of cardiac myxoma detected. After the operation, the body temperature rose to 37.8 °C for 7 days, which later returned to normal. A feature of the microstructure of this cardiac myxoma was a large number of inflammatory foci in the form of leukocyte infiltrates, often with foci of necrosis and destruction in the center, characteristic of abscesses. In the areas of inflammation there were basophilic clusters of microorganisms, which might be morphologically classified as Toxoplasma gondii. According to the classification of S.G. Revankar et al., the described histological findings allow in this case to diagnose «definite infected cardiac myxoma». The described clinical case is a first confirmed case of myxoma infection in our practice. The characteristic clinical features of the disease are supplemented by the results of histopathological examination, which revealed the causes of the temperature reaction.
{"title":"Infected cardiac myxomas: state of the problem and a cardiac surgery case","authors":"R. M. Vitovskyi, V. V. Isaіenko, T. I. Dedkova, O. Pishchurin, V. Zakharova, A.D. Kipioro","doi":"10.31928/2305-3127-2022.3-4.5561","DOIUrl":"https://doi.org/10.31928/2305-3127-2022.3-4.5561","url":null,"abstract":"The article presents a case of a truly infected heart myxoma in a 25-year-old patient. His main complaint during hospitalization was a daily increase in body temperature for 8 months up to 39 °C. Resection of the tumor was performed. During the surgery, a tumor typical of cardiac myxoma detected. After the operation, the body temperature rose to 37.8 °C for 7 days, which later returned to normal. A feature of the microstructure of this cardiac myxoma was a large number of inflammatory foci in the form of leukocyte infiltrates, often with foci of necrosis and destruction in the center, characteristic of abscesses. In the areas of inflammation there were basophilic clusters of microorganisms, which might be morphologically classified as Toxoplasma gondii. According to the classification of S.G. Revankar et al., the described histological findings allow in this case to diagnose «definite infected cardiac myxoma». The described clinical case is a first confirmed case of myxoma infection in our practice. The characteristic clinical features of the disease are supplemented by the results of histopathological examination, which revealed the causes of the temperature reaction.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75254060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-16DOI: 10.31928/2305-3127-2022.3-4.514
Y. Skybchyk, К.O. Mikhaliev, O. Zharinov
The article discusses controversial aspects of modern management of patients with persistent atrial fibrillation (AF). The appearance of a persistent form of AF is mainly a consequence of the processes of fibrosis and electrical restructuring (remodeling) of the atrial tissue. However, the question of the causes and mechanisms of the formation of fibrosis of the atrial tissue is quite debatable. The suggestions of experts regarding the division of persistent AF depending on the features of the arrhythmological anamnesis are presented: the appearance of persistent episodes of AF as a stage of disease progression in patients who previously had a paroxysmal form of arrhythmia, or «persistent AF from the beginning». From the standpoint of predicting the course of the disease and differentiating the management of patients, there are also grounds for distinguishing «early persistent AF» in cases where the duration of the episode is more than 7 days and less than 3 months, as well as «late persistent AF» lasting from 3 to 12 months. From the point of view of evidence-based medicine, the paradigm of managing patients with persistent AF is shifting towards the fastest and most aggressive fight for sinus rhythm. Changes in favor of the rhythm control strategy have largely occurred due to the rapid development of catheter treatment technologies. Its effectiveness is generally lower than in paroxysmal AF, which is due to more pronounced structural remodeling of the atria, as well as electrophysiological changes in the myocardium against the background of a prolonged episode of arrhythmia. At the same time, research into new techniques using modification of the arrhythmia substrate is ongoing.
{"title":"Variants of development and management of patients with persistent atrial fibrillation","authors":"Y. Skybchyk, К.O. Mikhaliev, O. Zharinov","doi":"10.31928/2305-3127-2022.3-4.514","DOIUrl":"https://doi.org/10.31928/2305-3127-2022.3-4.514","url":null,"abstract":"The article discusses controversial aspects of modern management of patients with persistent atrial fibrillation (AF). The appearance of a persistent form of AF is mainly a consequence of the processes of fibrosis and electrical restructuring (remodeling) of the atrial tissue. However, the question of the causes and mechanisms of the formation of fibrosis of the atrial tissue is quite debatable. The suggestions of experts regarding the division of persistent AF depending on the features of the arrhythmological anamnesis are presented: the appearance of persistent episodes of AF as a stage of disease progression in patients who previously had a paroxysmal form of arrhythmia, or «persistent AF from the beginning». From the standpoint of predicting the course of the disease and differentiating the management of patients, there are also grounds for distinguishing «early persistent AF» in cases where the duration of the episode is more than 7 days and less than 3 months, as well as «late persistent AF» lasting from 3 to 12 months. From the point of view of evidence-based medicine, the paradigm of managing patients with persistent AF is shifting towards the fastest and most aggressive fight for sinus rhythm. Changes in favor of the rhythm control strategy have largely occurred due to the rapid development of catheter treatment technologies. Its effectiveness is generally lower than in paroxysmal AF, which is due to more pronounced structural remodeling of the atria, as well as electrophysiological changes in the myocardium against the background of a prolonged episode of arrhythmia. At the same time, research into new techniques using modification of the arrhythmia substrate is ongoing.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87519497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-16DOI: 10.31928/2305-3127-2022.3-4.4854
S. Sheludko, A.S. Batsyun, Ye.V. Prokopenko, T.M. Symonenko, M. Yaremenko, S.Yu. Marikutsa
Pulmonary embolism is a disease associated with significant prevalence. Incidence of venous thromboembolism in countries of Europe is 100–200 cases per 100 thousand per year. Annual morbidity for venous thromboembolism in the United States is 71–117 cases per 100 000. Surgical pulmonary thrombectomy is an effective method of treatment, however, remains ambiguous due to the small number of multicenter studies. In this case report the result of surgical treatment of patient with acute massive pulmonary embolism is presented.
{"title":"Clinical case of surgical treatment of pulmonary embolism","authors":"S. Sheludko, A.S. Batsyun, Ye.V. Prokopenko, T.M. Symonenko, M. Yaremenko, S.Yu. Marikutsa","doi":"10.31928/2305-3127-2022.3-4.4854","DOIUrl":"https://doi.org/10.31928/2305-3127-2022.3-4.4854","url":null,"abstract":"Pulmonary embolism is a disease associated with significant prevalence. Incidence of venous thromboembolism in countries of Europe is 100–200 cases per 100 thousand per year. Annual morbidity for venous thromboembolism in the United States is 71–117 cases per 100 000. Surgical pulmonary thrombectomy is an effective method of treatment, however, remains ambiguous due to the small number of multicenter studies. In this case report the result of surgical treatment of patient with acute massive pulmonary embolism is presented.","PeriodicalId":9540,"journal":{"name":"Cardiac Surgery and Interventional Cardiology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75049051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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