Abstract:

Background: study presents data of recanalization of occlusions of access vein in patients after pacemaker implantation.

Material and methods: for the period of 2010-2018 a total of 461 patients underwent repeated antiarrhythmic device implantation. In 82(17,8%) patients we found malfunctioning leads. Total venous occlusion was found in 8(10%) cases. Attempt of recanalization was performed in 4 patients, in rest 4 cases recanalization was not performed, because of different reasons, and in 1 case it was unsuccessful.

Results: In 3 cases successful recanalization of venous occlusion and leads reimplantation were performed. In 2 cases - recanalization was performed using a guidewire and in 1 case a dilator for leads extraction was used. 5 patients underwent the contralateral implantation of a completely new system were performed.

Conclusions: recanalization of venous occlusion using a guidewire or a dilator is an effective method of treatment. These techniques allow to save contralateral access for other lifesaving procedures. However, recanalization using a dilator sheath might be associated with greater risk of complications such as perforation of subclavian vein, innominate vein or superior vena cava.

Thus, the choice of one or another strategy of recanalization is associated with technical difficulties and requires specialized tools and special skills of operating surgeon.

References

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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. 

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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. 

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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.   

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