Article exists only in Russian.

Abstract:

At 246 patients with coarctation of the aorta the ultrasonic semiotics of disease has been investigated. Are systematized echocardiographycal attributes of defect: are determined direct and indirect (displays directly reflecting morphology), the estimation of their sensitivity and specificity is lead. The certain combination of the specified attributes has allowed to allocate three variants of a ultrasonic picture coarctation of the Aorta, reflecting various anatomic forms of defect. The semiotics and diagnostic attributes of each ultrasonic variant of defect is described by echocardiography. 

Reference 

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Abstract:

The systolic pressure gradient at the level of aortic narrowing, determined by non-invasive methods was measured in 110 patients with aortic coarctation and compared with its value in direct measurement before and during various terms after correction of the defect. It was determined that Doppler ultrasonography of arteries of the limbs is the most informative non-invasive method of assessing the degree of narrowing/restoration of the aortic isthmus. Also showed was various informative value of Doppler cardiography as a method aimed at evaluating the efficacy of removing the defect in patients with good, satisfactory and poor therapeutic outcomes. 

Reference

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4.     Фейгенбаум Х. Ультразвуковая диагностика. М.: Медицина, 1999; 1123-1145.

5.     Шиллер Н., Осипов М.А. Клиническая эхокардиография. М.: 1993.

6.     Stephen F.K., et al. Quantitative echo cardiographic analysis of the aortic arch predicts outcome of balloon angioplasty of native coarctation of the aorta. Circulation. 1996; 94: 1056-1062.

7.      Шахов Б.Е., Рыбинский А.Д., Шарабрин Е.Г. Критерии оценки результатов коррекции коарктации аорты. Нижегород. мед. журнал. 2003; 3: 7-11.

8.      Рыбинский А.Д. Отдаленные результаты хирургического лечения коарктации аорты в возрастном аспекте. Дисс. канд. мед. наук. Горький. 1977.

Abstract:

Purpose. To assess the effectiveness of palliative endovascular interventions in patients with CTO anatomy infavorable for recanalisation.

Material and methods. The authors analyzed the results of interventions in 60 patients (50 male (83,3%), 10 female (16,7%)) aged 38 – 75 years (mean age 53,9±3,2), with occlusive coronary disease. Palliative revascularizations were performed in 30 patients, and CTO recanalization was done in 30 cases. The LV function was assessed echocardiographically in both groups before and after the intervention.

Results. 12 month follow-up showed significant improvement or normalization of LV function in both groups. Results of palliative interventions were shown to be as effective as recanalization of CTO.

Conclusions. Endovascular palliation is effective in treatment of patients with coronary CTO. It results in myocardial function improvement comparable to that in patients with complete coronary revascularization.   

References

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Abstract:

Coronary flow limitation during high risk angioplasty in acute coronary syndrome (ACS) patients is an important problem, connecting with inadequate myocardial protection during the coronary intervention.

Aim: was to compare intraoperative cardiohemodynamic in ACS patients during the high risk angioplasty of difficult stenoses in anterior heart arteries with- or without a coronary venous retroperfusion support.

Methods: intervention results of 14 ACS patients were analyzed. In 1st group there were 6 patients (42,9%) with intraoperative myocardial retroperfusion support. In 2nd group - 8 patients (57,1%) without any intraoperative myocardial perfusion support.

Results: during the retroperfusion support in the 1st group , «ST»-segment elevation at 60 sec left main (LM) or left anterior descending artery (LAD) occlusion was significantly lower (ST in V4-V6 - 1,9±1,7 mm) than in patients without retroperfusion (ST in V4-V6 - 3,1±1,7; p = 0,043). In the 2nd group, patients without coronary flow support the «ST»-segment elevation at 60 sec LM or LAD occlusion was significantly higher (ST в V4-V6 - 2,5±0,5; p = 0,043) than at 5 sec LM or LAD occlusion. No significant differences between «ST»-segment and «T»-wave deviation in the beginning and in the end of intervention were in both groups. The same dynamics was demonstrated at the time of blood pressure indexes measurement.

Conclusion: coronary venous retroperfusion is an effective method of coronary flow support during the high risk angioplasty in ACS patients. Retroperfusion technology had no influence on cardiohemodynamic, but reduced the risk of intraoperative adverse cardiac events. 

References

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Abstract:

Revascularization strategy definition in acute coronary syndrome in patients with multivessel coronary artery disease is a significant problem of modern intervention cardiology Aim: was to evaluate effectiveness of special PC programs «Sapphire 2015 - Right dominance» and «Sapphire 2015 - Left dominance» designed to the revascularization strategy definition ir acute coronary syndrome patients.

Materials and methods: revascularization strategy of 50 acute coronary syndrome patients was analyzed. In all cases the revascularization strategy was defined by the group of intervention cardiologists with the help of independent experts and special PC programs «Sapphire 2015 - Right dominance» and «Sapphire 2015 - Left dominance». Experts-, physicians-, and soft- based revascularization strategies were compared among themselves.

Results: complete coincidence between expert-based and soft-based revascularization strategies was registered in 66% patients and the incomplete coincidence - in 32% patients. Complete mismatch between expert-based and soft-based revascularization strategies was registered in 2% patients. The complete coincidence between physicians-based and soft-based revascularization strategies was registered in 42% patients and the incomplete coincidence - ir 52% patients. Complete mismatch between physicians-based and soft-based revascularization strategies was registered in 6% patients

Conclusion: as well as experts, special PC programs «Sapphire 2015 - Right dominance» and «Sapphire 2015 - Left dominance» provide success in the revascularization strategy definition 1г acute coronary syndrome patients with multivessel coronary artery disease.

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13.   Bainey K.R., Mehta S.R., Lai T. et al. Complete versus culprit only revascularization for patients with multivessel disease undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review and meta-analysis. Am. Heart J. 2014; 167: 1-14.