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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2.        Meier B. Chronic total coronary acclusion angioplasty. Cathet Cardiovasc. Diagn, 2006; 25: 1–11.

3.        Ганюков В.И., Осиев А.Г. Частные вопросы коронарной ангиопластики. Новосибирск. 2002; 4–23.

4.        Лопотовский П.Ю., Яницкая М.В. Клинический эффект эндоваскулярной реперфузии миокарда в бассейне длительно окклюзированной коронарной артерии. Между народный журнал интервенционной кардиоангиологии. 2006; 10: 22–26.

5.        Султан М.В. Реваскуляризация миокарда при остром коронарном синдроме. Авто-реф. дис. канд. мед. наук. М. 2006: 15–20.  

6.        Иоселиани Д.Г., Громов Д.Г., Сухоруков О.Е., Хоткевич Е.Ю., Семитко С.П., Исаева И.В., Верне Ж.-Ш., Арабаджян И.С., Овесян З.Р., Алигишева З.А. Хирургическая и эндоваскулярная реваскуляризация миокарда у больных с многососудистым поражением венечного русла: сравнительный анализ ближайших и среднеотдаленных результатов. Международный журнал интервенционной кардиоангиологии. 2008; 15: 22–31.

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8.        Ott R.A., Tobis J.M., Mills T.C., Allen B.J., Dwyer M.L. ECMO assisted angioplasty for cardiomyopathy patients with unstable angina. Department of Cardiothoracic Surgery, University of California. Irvine Medical Center. 2006.  

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11.      Петросян Ю.С., Иоселиани Д.Г. О суммарной оценке состояния коронарного русла у больных ишемической болезнью сердца. Кардиология. 1976; 12 (16): 41–46.

12.      Петросян Ю.С., Шахов Б.Е. Коронарное русло у больных с постинфарктной аневризмой левого желудочка сердца. Горький. 1983; 17–37.

13.      Rahimtoola S.H. The hibernating myocardium. Ibid. 1989; 117: 211–221.

Abstract:

Aim: was to investigate possibilities of multislice computed tomography in estimation of stenosis degree in coronary arteries in patients with ischemic heart disease (IHD).

Materials and methods: we examined 64 patients (18 female, 46 male, mean age 62,4± 9,5 years), who primary had been admitted to hospital and had high risk of IHD; and those who had early diagnosed IHD of 1,2,3 and 4 functional class, they were hospitalized for condition correction. Mainly spreaded risk factor was arterial hypertention in 55 patients - (85,9%) with highest level 200/100 mm hg and minimal 140/80 mm hg. All patients underwent multislice computed tomography (MSCT) on the 256-slice tomography station «Somatom definition flash (Siemens, Germany)»: collimation 128 x 0,6, the temporal resolution of 75 ms and a spatial resolution of 0.33 mm, slice thickness of 0.6 mm, with simultaneous use of two tubes with different voltage (kV 120/100), the current mAs - with programs to reduce radiation exposure Care Dose - is calculated automatically according to the constitution of man.

Post-processing of obtained data was performed on a workstation Syngo Via, in the application of CT-Soronary with automatic longitudinal separation of each coronary artery In view of image quality was analyzed data from end-diastolic phase of the cardiac cycle (80% R-R), or evaluated complex of multiphase images. We analyze the state of the main arteries of the main coronary: left anterior descending artery, the circumflex artery and the right coronary artery (LAD, CA, RCA). We performed estimation of coronary artery stenosis of segments according to the American Heart Association (AHA). Results were displayed in percentage. Obtained data was compared with those obtained using the reference method - X-ray coronary angiography, which was performed according to standard protocol

Results: comparison of results of coronary angiography and MSCT using correlation analysis showed the presence of strong direct significant correlation coefficients in the evaluation of coronary artery disease according to two methods. It was demonstrated a high inter-operator and intraoperator reproducibility of MSCT in the study of vessels conditions. Following characteristics of the method related to the identification of coronary artery stenosis segments: sensitivity - 95.8%, specificity - 92.8%, diagnostic accuracy - 95.1%, positive predictive value - 97.9%, negative predictive value - 86.6 %.

It was concluded that the high importance of the method of MSCT in the diagnosis of cardiovascular diseases and the need for its widespread use in cardiology practice.  

References 

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2.    Данилов Н.М., Матчин Ю.Г. и др. Показания к проведению коронарной артериографии. Consilium Medicum. Болезни сердца и сосудов. 2006; 1(1). Danilov N.M., Matchin Yu.G. et al. Pokazaniya k provedeniyu koronarnoy arteriografii. Consilium Medicum. Bolezni serdtsa i sosudov. [Indications for coronary arteriography. Consilium Medicum heart disease and vascular. ]2006; 1(1) [In Russ.].

3.    Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

4.    Sun Z., Aziz YF., Ng K.H. Coronary CT angiography: how should physicians use it wisely and when do physicians request it appropriately. Eur. J. Radiol. 2012; 81: 684-687.

5.    Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography. Am. Heart J. 2005; 149: 1112-1119.

6.    Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

7.    Achenbach S., Marwan M., Schepis T. et al. High-pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

8.    Budoff M.J., Dowe D., Jollis J.G. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J. Am. Coll. Cardiol. 2008; 52: 1724-1732.

9.    Petcherski O., Gaspar T., Halon D. et al. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am. J. Cardiol. 2013; 111: 510-515.

10.  De Graaf F.R., Schuijf J.D., Van Velzen J.E. et al. Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. Eur. Heart J. 2010; 31: 1908-1915.

Abstract:

Aim: was to show possibilities of magnetic resonance imaging (MRI) in the detection and characterization of neoplasms of the heart.

Materials and methods: we retrospectively studied clinical cases of heart neoplasms, diagnosed and operated in Federal National Center of Cardiovascular Surgery (FNCCS) (Penza) since 2008 tc 2014. All patients on admission underwent echocardiography, after which, in some cases to clarify the topography of neoplasms and features of individual anatomy - MRI was performed. In postoperative follow-up period, control studies were conducted. In all cases, the diagnosis was histologically verified. All operated patients were discharged in satisfactory condition. We made a search and analysis of scientific literature on beam diagnostics of space-occupying lesions of heart.

Results: for the period of 6 years, in FNCCS were examined and surgical treatment of more than 30 thousand patients, of which neoplasms of the heart were detected in 25(0.08%) cases. Cardiac myxoma was diagnosed in 19(76%) patients, of whom in 2(8%) cases, the echocardiographic picture was mixed, that had required magnetic resonance imaging. MRI has also been used in 2(8%) patients with benign and malignant transformation of mesenchyoma, and in few cases (4%) rhabdomyomas, lipomatous hypertrophy, atrial septum, epithelioid leiomyoma of the uterus in the germinating atrium and metastatic melanoma. Also, in some cases, the use of MRI allowed to rule out malignancy and to identify mural thrombus. In 1 case, MRI gave, a detailed study of the morphology and localization of tumors to evaluate its spatial relationship with neighboring structures, study of three-dimensional and functional parameters of the heart. Dynamic mode (Cine-SSFP), planar and volumetric reconstruction (MPR) demonstrated the topography of tumors. That helped a broad understanding of the pre-operative pathology and surgical simplified decision-making. MRI allowed to analyze results of surgical correction and implement dynamic monitoring during the early and late postoperative period.

Conclusions: MRI in the diagnosis of tumors of the heart significantly complements echocardiography, providing a non-invasive multi-modal visualization, necessary for a comprehensive assessment of the topography of lesions, detection of individual anatomical features of intracardiac and extracardiac structures. MRI should be included in the diagnostic algorithm of tumors of the heart, including to assess occured hemodynamic changes.  

References 

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3.    Moynihan T. J. Is there such a thing as heart cancer? http: www.mayoclinic.org/heart-cancer/expert-answers/ faq-20058130.

4.    Roberts W.C. Neoplasms involving the heart, their simulators, and adverse consequences of their therapy. Bayl Univ. Med. Cent. 2001; 14:358-376.

5.    Sutsch G., Jenni R., L. von Segesser, Schneider J. Heart tumors: incidence, distribution, diagnosis exemplified by 20,305 echocardiographies. Schweiz. Med. Wochenschr. 1991; 121:621-629.

6.    Goswami K.C., Shrivastava S., Bahl V.K., et al. Cardiac myxomas: clinical and echocardiographic profile intern J. Cardiol. 1998; 63 (3):251-259.

7.    Bogaert J., Dymarkowski S., Taylor A.M. Clinical Cardiac MRI. Springer 2005; 549.

8.    Buckley O., Madan R., Kwong R., et al. Cardiac Masses, Part 1: Imaging Strategies and Technical Consideration. AJR. 2011; 197:837-841.

9.    O’Donnell D.H., Abbara S., Chaithiraphan V., et al. Cardiac Tumors: Optimal Cardiac MR Sequences and Spectrum of Imaging Appearances. AJR. 2009; 193: 377387.

10.  Finn J.P, Nael K., Deshpande V., et al. Cardiac MR imaging: state of the technology. Radiology. 2006; 241:338-354.

11.  Fussen S., De Boeck B.W., Zellweger M.J., et al Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours. Eur. Heart J. 2011; 32(12):1551-1560.

12.  Belenkov Ju.N., Sinicin V.E., Ternovoj S.K. Magnitno-rezonansnaja tomografija serdca i sosudov[MRI of heart and vessels]. Vidar. 1997; 144 р [In Russ].

13.  Bokerija L.A., Malashenkov A.I., Kavsadze V. Je., Serov R.A. Kardioonkologija [Cardiology]. NCSSH im. A.N. Bakuleva RAMN. 2003; 254 р [In Russ].

14.  Burke A., Virmani R. Atlas of Tumor Pathology. Tumors of the Heart and Great Vessels. Armed Forces Institute of Pathology. 1996.

15.  Butany J., Leong S.W., Carmichael K., Komeda M. A 30-year analysis of cardiac neoplasms at autopsy. Can. J. Cardiol. 2005; 21:675-680.

16.  Telen M., Jerbel R., Krejtner K-F., Barkhauzen J. Luchevye metody diagnostiki boleznej serdca [Beam methods of diagnostics of heart diseases]. MEDpress-inform. 2011; 408 р [in Russ].

17.  Hanson E.C. Cardiac tumors: a current perspective. NY State J. Med. 1992; 92:41-42.

18.  Amano J., Kono T., Wada Y, et al. Cardiac myxoma: its origin and tumor characteristics. Ann. Thorac. Cardiovasc. Surg. 2003; 9:215-21.

19.  Araoz PA., Mulvagh S.L., Tazelaar H.D., et al. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 2000; 20:1303-19.

20.  Buckley O., Madan R., Kwong R., et al. Cardiac Masses, Part 2: Key Imaging Features for Diagnosis and Surgical Planning. AJR. 2011; 197:842-851.

Abstract:

Palliative surgery plays a major role as a stage of congenitalheart disease treatment.Palliative endovascular interventions are safe n neonates. Such treatment can stabilize patients and adequately prepare them for radical operation and in some cases it is an alternative to classic bypass methodic.

References

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2.    Rosano A. et al. Infant mortality and congenital anomalies from 1950 to 1994. An international perspective. J. Epidemiol. Community Health. 2000; 54: 660-666.

3.    Шарыкин А.С. Врожденные пороки сердца. Руководство для педиатров, кардиологов, неонатологов. М.: изд-во «Теремок». 2005; 8-14, 224-234.

4.    Любомудров В.Г., Кунгурцев В.Л., Болсуновский В.А. и др. Коррекция врожденных пороков сердца в периоде новорожденности. Российский вестник перинатологии и педиатрии. 2007; 3: 9-13.

5.    Lacour-Gayet F., Anderson R.H. A uniform surgical technique  for transfer of both simple and complex patterns of the coronary arteries during the arterial switch procedure. Cardiol. in the Young. 2005; 15 (1): 93-101.

6.    Gibbs J.I. Treatment options for coarctation of aorta. Heart. 2000; 84: 11-13.

7.    Zales V.R., Muster A.J. Ballon dilatation angioplasty for the management of aortic coarctation. In C. Mavroudis, C.L. Backer et al. Coarctation and interrupted aortic arch. Cardiac surgery. State of art review. Philadelphia. Huley & Belfus. 1993; 7: 133.

8.    Chen Q., Parry A.J. The current role of hybrid procedures in the stage 1 palliation of patient with hypoplastic left heart syndrome. Eur. J.Cardiolthorac. Surg. 2009; 36: 77-83.

9.    Michel-Behnke I. et al. Stent implantation in the ductus arteriosus for pulmonary blood supply in congenital heart disease. Catheter. Cardiovasc. Interv. 2004; 61  (2): 242-252. 10.  

10.  Bisoi A.K. et al. Primary arterial switch operation in children presenting late with d-transposition of great arteriaes and intact ventricular septum. When is it too late for a primary arterial switch operation? Eur. J. Cardiothorac. Surg. 2010; 38: 707-713.

Abstract:

We have analyzed long-term results of different revascularization strategies in 171 patients with multivessel coronary artery defeat. Duration of follow up observation ranged from 12 to 18 months. Complete revascularization of the myocardium was performed in 63 pts, culprit vessel revascularization - in 86 and incomplete revascularization - in 22 patients. All patients undervwent SYNTAX scoring analysis to find out possible risks of transcutaneus coronary interventions. Survival rate, incidence of myocardial infarction, repeat myocardial revascularization procedures and major adverse cardiac events were comparable among the patients with low and intermediate SYNTAX Score. Among the patients with high SYNTAX Score the incidence of myocardial infarction (8,82%, р = 0,002), repeat PCI procedure (32,35%, р = 0,001) and major adverse cardiac events (32,35%, р = 0,002) was reliably higher compared to patients with low and intermediate SYNTAX Score. The mpact of the SYNTAX Score rate on the long-term results in the different revascularization strategy groups was also analyzed. In the 1st group the incidence of major adverse cardiac events among the patients was comparable. In the 2nd group patients with the high SYNTAX Score rate had reliably higher rate of major adverse cardiac events (43,75%, р = 0,002). The rate of major adverse cardiac events were higher in the 3rd group of patients with the high SYNTAX Score rate compared in patients with low and intermediate SYNTAX Score rate, but this difference didn't reach statistically reliable difference. Use of the strategy of culprit vessel revascularization in the patients with high SYNTAX Score rate, leads to increased rate of major adverse cardiac events and repeat PCI procedures in the long-term follow up period.

References 

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6.    Ijsselmuiden A.J.J. et al. Complete versus culprit vessel percutaneous coronary intervention in multivessel disease. A randomized comparison. Am. Heart. J.2004; 148: 467-474.

7.    Martuscelli E. et al. Revascularization strategy in patients with multivessel disease and a major vessel chronically occluded. Data from the CABRI trial. Eur. J. of Card.Thorac. Surg. 2008; 33: 4-8.

8.    Van den Brand M.J.B.M. et al. The effect of completeness of revascularization on event-free survival at one year in the arts trial. J. Am. Col. Cardiol. 2002; 39; 559-564.

9.    Беленков Ю.Н., Акчурин Р.С., Савченко А.П. и др. Результаты коронарного стентирования и хирургического лечения у больных ИБС с многососудистым поражением коронарного русла. Кардиология. 2002; 5: 42-45.

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Abstract:

Purpose. Оf the study was to determine abilities of multislice spiral tomography (MSCT) in detection coronary artery disease (CAD) in patients with atypical angina..

Material and methods. Sixty patients (39 men) with atypical chest pain and suspected ischemic heart disease underwent complex diagnostic strategy. Value of MSCT in detection of significant (more than 50%) coronary artery stenoses was assessed by segmental analysis, vascular bed involvement, and patient analysis.

Results. Significant CAD in 8% of patients with atypical angina was revealed. In 98,7% (58 of 60 cases) MSCT allowed to specify coronary anatomy. In 53 (88,3%) of patients no significant CAD was found, in 5 cases (8,3%) MSCT confirmed significant coronary artery stenoses. Sensitivity, specificity, positive and negative prognostic value of MSCT were correspondingly 100%, 99,3%, 71,4%, 100% in segmental analysis (n = 295). Vascular territory involvement analysis (n = 91) showed 100% sensitivity, 97,7% specificity, positive prognostic value 71,4% and negative prognostic value 100%.

Conclusions. High prognostic value, as well as high sensitivity and specificity of MSCT allow us to include this method into the CAD diagnostic algorithm in patients with atypical chest pain. This method is highly reliable in eliminating of significant CAD and detecting coronary artery stenoses.

References 

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4.      Leber A.W. et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. A comparative study with quantitative coronary angiography and intravascular ultrasound. J. Am. Coll. Cardiol. 2005; 46: 147-154.

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11.    Leber A.W. et al. Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur. Heart. J. 2007; 28: 2354-2360.

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Abstract:

We performed echocardiographic evaluation of 149 women with congenital and acquired heart defects prior to their pregnancy and during the 3d trimester of gestation, as the hemodynamic load reached its peak. It was shown that in patients with surgically corrected cardiac anomalies, echocardiographic findings could stay within physiological limits, otherwise we saw inadequate hemodynamic response and structu-ralchanges.

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8.            Елисеев О.М. Сердечно-сосудистые заболевания у беременных. М.: Медицина. 1994; 246. 

9.           Жигунова И.А. Оценка неспецифических адаптационных механизмов у женщин в III триместре беременности. Автореф. дис.канд. мед. наук. Рязань. 2002; 15.

10.        Затикян Е.П. Врожденные и приобретенные пороки сердца у беременных. М.: Триада-Х. 2004; 294.

11.        Гриффин Б., Тополь Э. Кардиология. М.:Практика. 2008; 673.

12.        Кулавский В.А., Огий Т.И. Физиология и патология сердца у беременных. Уфа. 2000; 198.

13.        Тетелютина Ф.К. Прогнозирование, доклиническая диагностика и профилактика перинатальной патологии у беременных с пороками сердца. Дис. Д-ра мед. наук (Казанская государственная медицинская академия). 2002; 176.

Abstract:

A case report of right ventricular outlet (RVO) stenting as palliative treatment of pulmonary artery atresia (PAA) in combination with interventricular septum defect (ISD), in situation when radical surgical intervention has high operative risk due to condition severity and low weight RVO stenting in newborn and children with low weight is made seldom and noted as a case reports. Peculiarity of this case is that intervention was made in patient with extremely low weight and age (age - 6 month, weight - 3 kg) after performed early central aorto-venous bypass and further palliative reconstruction of right ventricular outflow.

References

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3.     Wernovsky G., RubensteinS.D., Spray T.L. Cardiac surgery in the low-birth weight neonate: new approaches. Clin. Perinatol. 2001; 28:249-4.

4.     Laudito А., Varsha M., Bandisode J., Lucas F. et al. Right Ventricular Outflow Tract Stent as a Bridge to Surgery in a Premature Infant with Tetralogy of Fallot. Ann. Thorac. Surg. 2006; 81:744-746.

5.     Kirklin J. V., Barrat-Boyes. Cardiac surgery J V. New York: Churhill Livingstoun 2003.

6.     Sahu Raj., Syamasundar Rao., Transcatheter Stent Therapy in Children: An Update. Pediat. Therapeut. 2012, S5.

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9.     Sugiyama H., Williams W., Benson L.N. Implantation of endovascular stents for the obstructive right ventricular outflow tract Heart. 2005; 91:10581063.doi:10.1136/ hrt.2004.034819.

10.   Alwi M., Alwi M., Choo K.K., Latiff H.A., et. al. Initial results and medium-term follow-up of stent implantation in patent ductus arteriosus in ductdependent pulmonary circulation. J. Am. Coll. Cardiology 2004; 44(2):438-45. 

11.   Gladman G., Mc Crindle B.W., Williams W.G., et. al. The modified blalock-taussig shunt: clinical impact and morbidity in Fallot’s tetralogy in the currentera. J. Thorac. Cardiovasc. Surg. 1997; 114:25-30.

Abstract:

Diseases of the circulatory system in a few decades are one of the major causes of death and disability in the population in many countries around the world. In Russian Federation, a number of newly diagnosed cases of coronary heart disease and mortality of the working population of this pathology is growing. In clinical practice at the present time, various radiological techniques assess the condition of the heart and coronary vessels, determine the location and volume of lesions. In the available literature, however, we found no data on methods of research that would reveal the correlation between the X-ray anatomy of coronary vessels and structural and functional state of the heart muscle. Thus, the need for comprehensive scientific research is obvious. Results of this study will, on the basis of survey data, using the methods of radiation diagnosis, objectively assess the level of metabolic and structural and functional state of the cardiomyocytes in cardiac patients. This will improve the accuracy and informativeness of diagnosis, as well as the increase of the control of effectiveness of therapy and quality of patients' life with cardiac diseases. 

References

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14.   Veselova T.N., Merkulova I.N., Yarovaya E.B., Ruda M. J. Evaluation of myocardial viability Metolit MSCT for the prediction of postinfarction left ventricular remodeling. Regional circulation and microcirculation. 2013, 1 (45): 17-24 [In Russ].

15.   Stukalova O.V., Vlasova, E.E., Tarasov L.V., Ternovoy S.K. Magnetic resonance imaging of the heart in patients with postinfarction cardiosclerosis preoperative surgical myocardial revascularization. Regional circulation and microcirculation. 2013, 1 (45): 36-41[ In Russ].

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29.   Ryzhkova D.V., Kolesnychenko M.G., Boldueva S.A., Kostin J.S. The study of coronary hemodynamics methods of positron emission tomography in patients with cardiac syndrome X. Siberian Medical Journal (Tomsk). 2012, 27 (2): 50-56 [In Russ].

30.   Nekolla S., Reder S., Saraste A. et al. Evaluation of the Novel Myocardial Perfusion Positron-Emission Tomography Tracer 18F-BMS-747158-02: Comparison to 13N-Ammonia and Validation With Microspheres in a Pig Model. Circulation. 2009; 119(17): 2333-2342. 

31.   Gerber B.L., Ordoubadi F.F., Wijns W. et al. Positron emission tomography using 18F-fluoro-deoxyglucose and euglycaemic hyperinsulinaemic glucose clamp: optimal criteria for the prediction of recovery of post-ischemic left ventricular dysfunction. Results from the European Community concerted action multicenter study on use of 18F- fluorodeoxyglucose positron emission tomography for the detection of myocardial viability. Eur. Heart. J . 2001: 22: 1691-701.

Abstract:

Surgical treatment of aortic valve pathology is an actual problem of modern medicine. Aortic valve pathology is widely spread in population on a stable high level. Due to a large amount of patients with no possibility of open surgical treatment of aortic valve pathology modern hybrid methods of treatment, such as transcatheter aortic valve implantation are being actively proposed and modified.

MSCT angiography before transcatheter aortic valve implantation is obligatory procedure. Data obtained by MSCT is extremely necessary to define the possibility and the access path of transcatheter aortic valve implantation. MSCT allows to select the size and type of aortic valve prosthesis.

Appearance of modern MSCT scanners with 320-640 row of detectors will increase the leading role of MSCT in preoperative inquiry of patients with planned transcatheter aortic valve implantation.

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Abstract:

Aim: was to study properties of nanostructured carbon coating stents in coronary arteries with the help of intravascular ultrasonic visualization.

Materials and Methods: experimental implantation of stents in coronary artery was performed on 8 yearling sheep. Estimation of bioinertness properties of stents was made by intravascular ultrasonic method on the 14, 28, 180 day. Bioinertness properties were estimated in comparison with analogical bare-metal stents.

Results: The analysis of results showed that in early stages (up to 28 days) experimental samples of stents cause less formation of trombus than simple balloon-extendable stents. In the period of late outcomes, coronary nanostructured carbon coating stents have lower level of «in-stent stenosis».

Conclusion: stent implantation with nanostructured carbon coating does not prevent the natural reparative processes taking place in the artery wall, does not cause the formation of thrombotic masses under standard doses of antiaggregants. Experimental stents significantly less affected in-stent stenosis, than stents without surface modification, indicating their higher bioinertness. 

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Abstract:

This case report is about endovascular treatment of pulmonary arteriovenous malformations accompanied by severe arterial hypoxemia in the newborn. The peculiarity of this case is the extreme rarity of manifestation and successful treatment of the pathology in infancy The second feature was the use of vascular occlude devices. Currently due to the sporadic clinical observations in newborn, we consider to appropriate description of this case, focusing on the technical aspects of the intervention. 

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15.   Белозеров Ю.М., Детская кардиология. М.: Медпрессинформ. 2004;167-180. Belozerov Ju. M., Detskaja kardiologija [Pediatrics cardiology]. M.: Med-pressinform. 2004;167-180 [In Russ]. 

Abstract:

Aim: was to analyse possibilities of multislice computed tomography in patients with coronary vessels' pathology

Results: we performed the analysis of published data on the use of multislice computed tomography in the coronary heart disease diagnostics. Data on the development of the method are presented: it is indicated that its diagnostic efficiency is related to technological improvements, accompanied by the appearance of each successive generation of multislice computed tomography The possibilities of using scanners from 16- to 230-slice scanners with two sources of energy, advantages of «dual energy» regime of application (dual-energy CT) in the coronary disease diagnostic are considered. Given constraints of the method diagnostic efficacy - artifacts associated with movements and severe calcification.

Conclusions: implementation of the method in cardiology practice can promote its consideration as a promising alternative to invasive diagnostic coronary angiography Further development of the technology can allow multislice computed tomography to become the main method of diagnosis of coronary heart disease and other cardiovascular diseases. 

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25.   Alkadhi H., Stolzmann P., Desbiolles L. et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010; 96: 933-938.

26.   Hou Y, Yue Y, Guo W. et al. Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography: image quality and radiation dose over expanded heart rates. Int. J. Cardiovasc. Imaging. 2012; 28: 153-162.

27.   Hou Y, Ma Y, Fan W. et al. Diagnostic accuracy of low-dose 256-slice multidetector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease. Eur. Radiol. 2014; 24: 3-11.

28.   Petcherski O., Gaspar T., Halon D. et al. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am. J. Cardiol. 2013; 111: 510-515.

29.   Van Velzen J.E., De Graaf F.R., Kroft L.J. et al. Performance and efficacy of 320-row computed tomography coronary angiography in patients presenting with acute chest pain: results from a clinical registry. Int. J. Cardiovasc. Imaging. 2012; 28: 865-876.

30.   Pelliccia F., Pasceri V., Evangelista A. et al. Diagnostic accuracy of 320-row computed tomography as compared with invasive coronary angiography in unselected, consecutive patients with suspected coronary artery disease. Int. J. Cardiovasc. Imaging. 2013; 29: 443-452.

31.   Gaudio C., Pelliccia F., Evangelista A. et al. 320-row computed tomography coronary angiography vs. conventional coronary angiography in patients with suspected coronary artery disease: a systematic review and metaanalysis. Int. J. Cardiol. 2013; 168: 1562-1564.

32.   Li S., Ni Q., Wu H. et al. Diagnostic accuracy of 320-slice computed tomography angiography for detection of coronary artery stenosis: meta-analysis. Int. J. Cardiol. 2013;168: 2699-2705.

33.   Barrett J.F., Keat N. Artifacts in CT: recognition and avoidance. Radiographics. 2004; 24: 1679-1691.

34.   Earls J.P. How to use a prospective gated technique for cardiac CT. J. Cardiovasc. Comput. Tomogr. 2009; 3: 45-51.

35.   Leschka S., Stolzmann P., Schmid F.T. et al. Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur. Radiol. 2008; 18: 1809-1817.

36.   Ketelsen D., Thomas C., Werner M. et al. Dualsource computed tomography: estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography. Eur. J. Radiol. 2010; 73: 274-279.

37.   Dikkers R., Greuter M.J., Kristanto W. et al. Assessment of image quality of 64-row Dual Source versus Single Source CT coronary angiography on heart rate: a phantom study. Eur. J. Radiol. 2009; 70: 61-68.

38.   Hoffmann U., Moselewski F., Nieman K. et al. Non-invasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions in stable angina by multidetector computed tomography. J. Am. Coll. Cardiol. 2006; 47: 1655-1662.

39.   Sun Z. Cardiac CT imaging in coronary artery disease: Current status and future directions. Quant Imaging Med. Surg. 2012; 2: 98-105.

40.   Halpern E.J., Savage M.P., Fischman D.L., Levin D.C. Cost-effectiveness of coronary CT angiography in evaluation of patients without symptoms who have positive stress test results. AJR Am. J. Roentgenol. 2010; 194: 1257-1262.

41.   Sun Z., Aziz YF., Ng K.H. Coronary CT angiography: how should physicians use it wisely and when do physicians request it appropriately Eur. J. Radiol. 2012; 81: 684-687. 

Abstract:

Aim: was to analyze long-term results of coronary artery stenting with drug-eluting stents «Zotarolimus» and bare metal stents in patients with a concomitant diabetes mellitus type II.

Materials and methods: 37 patients with ischemic heart disease and concomitant diabetes mellitus type II were selected for analysis; they underwent implantation of stents without drug coverage («Intergrity» «Medtronic») or stents with drug-eluting «Zotarolimus» («Resolute Integrity» «Medtronic»). All patients were divided into 2 groups: first group consisted of 11 patients, who underwent implantation of bare metal stents, second group - 26 patients who underwent implantation of drug-eluting stents, «Zotarolimus». Follow-up period was 26±4 months. Criteria of stenting efficiency were: angiographic assessment of coronary arteries anatomy in control angiography after stent implantation, reccurence of angina or functional class increase, the survival rate in the nearest postoperative period, before discharge, but not more than 30 days, and in the early post-operative period up to 6 months. In the medium-distant post-operative period - 12 months, and in the late postoperative period - 24 months.

Results: all patients underwent successfully performed endovascular revascularization. The optimal angiographic result was achieved in all patients. Regression of ischemic changes on ECG data and increase myocardial contractility by echocardiography data also were marked in all patients. In long-term follow-up period, in 5 (45%) patients with bare metal stents we noted the appearence of hemodynamically significant restenosis, that needed performance of secondary angioplasty with stenting.

Conclusion: the use of antiproliferative drug-eluting stents «Zotarolimus» is possible in treatment of patients with coronary artery disease and comorbid diagnosis of diabetes mellitus type II. Bare metal stents in coronary stenting in patients with concomitant diagnosis of diabetes mellitus type II is impractical due to developing in-stent restenosis (45% of patients). 

References

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2.     Petrova K.N., Kozlov S.G., Ljakishev A.A., Savchenko A.P. Vlijanie saharnogo diabeta 2 tipa na rezul'taty jendovaskuljarnogo lechenija IBS s pomoshhju stentov s lekarstvennym pokrytiem (dannye godichnogo nabljudenija) [Influence of diabetes mellitus type 2 on results of endovascular treatment of IHD with help of drug-eluting stents (data monitoring for one year)]. Kardiohgija. 2006; 12: 22-6 [In Russ].

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11.   Park K.W., Lee J.M., Kang S.H., Ahn H.S., Kang H.J., Koo B.K., Rhew J.Y, Hwang S.H., Lee S.Y, Kang T.S., Kwak C.H., Hong B.K., Yu C.W., Seong I.W., Ahn T., Lee H.C., Lim S.W., Kim H.S. Everolimus-eluting xience v/promus versus zotarolimus-eluting resolute stents in patients with diabetes mellitus. JACC. Cardiovasc. Interv. 2014 May;7(5):471-81. doi: 10.1016/j.jcin.2013.12.201. 

Abstract:

Aim: was to perform indirect estimation of pumping function of left ventricle (LV) in patients with ischemic heart disease (IHD), before and after mini-invasive intracoronary procedures or elimination of cardiac arrhythmias, basing on condition of pulmonary circulation.

Material and methods: research includes data of 44 patients with IHD (aged 43-89), who were admitted to the hospital with acute coronary syndrome (ACS) or cardiac arrhythmia. Estimation of pulmonary flow condition in IHD patients was made basing on data of chest multislice computec tomography (MSCT), changes of density of lung parenchyma in selected volume of lung before and after coronary stenting/placement of pacemaker, disruption of ectopic lesions and conduction pathway

Results: sighs of reliable changes in pulmonary circulation as local lung pneumatization changes with increased densitometric value within 10 hounsfield units (HU) after mini-invasive surgical treatment were found in 19 patients.

Conclusions: the study has showed high sensitivity of lung MSCT in diagnostics of left ventricular disfunction within coronary blood flow changes and normalization of cardiac rhythm. 

References

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4.     Koncevaja A.V, Kalinina A.M., Koltunov I.E., Oganov R.G. Social'no-jekonomicheskij ushherb ot ostrogo koronarnogo sindroma v Rossijskoj Federacii.GNIC profilakticheskoj mediciny [Social-economic lesion of acute coronary syndrome in Russian Federation]. Racionarnaja farmakoterapija v kardiologii. 2011 7(2): 158-166 [In Russ].

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22.   Gonzales J., Verin A. Non-Cardiogenic Pulmonary Edema, Lung Diseases - Selected State of the Art Reviews, Ed. Dr. Elvisegran M. I. 2012, ISBN: 978-953-51-0180-2, InTech, Available from:http://www.intechopen.com/ books/lung-diseases-selected-state-of-the-art- reviews/non-cardiogenic-pulmonary-edema.

23.   Min'ko B.A., Vologdina I.V., Borodich P.L. Rol' kompjuternoj tomografii legkih u bol'nyh ishemicheskoj boleznju serdca v ocenke funkcii levogo zheludochka pri maloinvazivnyh hirurgicheskih vmeshatel'stvah [The role of computed tomography of lungs in estimation of left ventricle function during mini-invasive interventions in patients with ischemic heart disease]. REJR. 2015; 5(1): 64-67 [In Russ]. 

Abstract:

Background: case report of a rare congenital anomaly - the diverticulum of the right ventricle of the heart, revealed by echocardiography and magnetic resonance imaging (MRI) of the heart.

Aim: was to show possibilities in detection and differential diagnosis of diverticulum of the right ventricle.

Materials and methods: patient, 23 years, during examination after passed pneumonia, underwent echocardiography wich revealed an aneurysm of right ventricle. Patient underwent further examination: MRI of heart in T1-WS and T2-WS, «gradient echo» and dynamical regime (Cine-SSFP) in standard positions. Demonstration of diverticulum is based on reconstruction imaging (MPR). Results: due to MRI data, in right ventricle we found a bulging 1,2х2,0 cm with clear contours, wich decreased in systole with myocardum of right ventricle - «true diverticulum of right ventricle». We marked difficulties in the diagnosis associated with the paucity of clinical manifestations.

Conclusions: MRI made it possible to study individual morphological anatomy of the diverticulum, to demonstrate and to assess in detail the topography that helped to make decisions on further management of the patient. 

References

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Abstract:

Despite the fact that so far in the literature, many cases of endovascular closure of paravalvular leak (PVL), this type of intervention is unusual and is associated with a complex technical issues. In addition, the majority of publications devoted to the correction of mitral and aortic PVL, while the description of the closing of the tricuspid valve (TV) PVL are rare.

Below is a description of our first experience of endovascular correction of TV PVL in 54 years ole patient, who underwent TV repair with «Neokor-32» - supporting ring as a correction of atrial septal defect, TV insufficiency One year after surgery the patient reported a decrease in physical activity tolerance. Echocardiography diagnosed hemodynamically significant PVL of TV, 6mm size with leakage between the left ventricle and the right atrium and formation of pulmonary hypertension. PVL was successfully treated by endovascular correction with using of device for closure of ventricular septal defect.  

References

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Abstract:

Aim: was to improve the efficiency of diagnosis of patients with coronary heart disease, by estimating of possibilities of cardiac multislice computed tomography in comparison with coronary angiography.

Materials and methods: study included 64 patients (18 women and 46 men, mean age 62,4 ± 9,5 years) with a high risk of developing coronary heart disease. In 34 patients - myocardial infarction in anamnesis (18 patients - in pool right coronary artery in 16 patients - in left anterior descending artery). Clinics of angina pectoris - in 40 patients (functional class (FC) I - 10; FC II - 22, FC III - in 6, FC IV - 2 patients). Selection criteria: the absence of disease progression for at least 6 weeks, and at least 3 months of optimal treatment. All patients underwent cardiac MSCT at 256-slice CT scanner. Obtained data was compared with data of reference method - x-ray coronary angiography.

Results: comparison of MSCT coronary angiography with invasive data showed a high comparability of results of two methods in the evaluation of coronary artery disease. It was revealed that discrepancies between cardiac MSCT and CAG in detection of hemodynamically insignificant stenoses ranging from 0 to 4%, hemodynamically significant stenoses - from 0 to 2.6%, subtotal stenosis - from 0 to 1%, occlusions - 0%. The presence of strong correlations between data of cardiac MSCT and coronary angiography of stenosis, demonstrated the high quality of MSCT imaging of coronary artery segments in the examination with a variety of modes of application method.

Conclusion: multislice computed tomography is a highly effective method for diagnosing of structural and anatomic changes of coronary arteries in patients with coronary heart disease.

References

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2.     Kokov L.S., Shutihina I.V., Timina I.E. Ispol'zovanie ul'trazvukovyh tehnologij v ocenke ateroskleroticheskih porazhenij sosudistoj stenki [The use of ultrasonic technology in the assessment of atherosclerotic lesions of the vascular wall.]. Molekuljarnaja medicina. 2013;4:15-25 [In Russ].

3.     Sinicyn V.E., Stukalova O.V., Docenko Ju.A. i dr. Kontrastnaja magnitno-rezonansnaja tomografija v ocenke rubcovyh porazhenij miokarda u bol'nyh IBS[Contrast magnetic resonance imaging in the evaluation of myocardial scarring lesions in patients with coronary artery disease.]. Diagnosticheskaja i intervencionnaja radiologija. 2009;3 (4):23-31 [In Russ].

4.     Fedotenkov I.S., Gagarina N.V., Veselova T.N., Sinicyn V.E., Ternovoj S.K. Kolichestvennyj analiz urovnja kal'cinoza koronarnyh arterij: sravnenie informativnosti mul'tispiral'noj komp'juternoj tomografii i jelektronno-luchevoj tomografii[Quantitative analysis of the level of calcification of the coronary arteries: comparison of informativeness of multislice computed tomography and electron beam tomography.]. Terapevticheskij arhiv. 2006;12:15-19 [In Russ].

5.     Ternovoj S.K., Veselova T.N., Sinicyn V.E. i dr. Rol' mul'tispiral'noj komp'juternoj tomografii v diagnostike infarkta miokarda [The role of multislice computed tomography in the diagnosis of myocardial infarction.]. Kardiologija. 2008; 1: 4-8 [In Russ].

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7.     Ustjuzhanin D.V., Veselova T.N., Sinicyn V.E. i dr. Cravnitel'nyj analiz diagnosticheskogo znachenija neinvazivnoj angiografii koronarnyh arterij s pomoshh'ju jelektronno-luchevoj i mul'tispiral'noj komp'juternoj tomografii [Comparative analysis of the diagnostic value of noninvasive coronary angiography using the electron beam and multislice computed tomography.]. Terapevticheskij arhiv. 2008; 4:12-15[In Russ].

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Abstract:

Aim: was to estimate parameters of left ventricle (LV) perfusion and kinetics at ischemic chronic heart failure (CHF), which initial values are predictors of increased myocardial functional reserve and patients clinical status improvement as a result of revascularization.

Materials and methods: examined 157 patients (146 men and 11 women; age from 33 to 72 years) before and in 2 - 3 days after percutaneous coronary intervention with diagnosis: CAD, CHF with NYHA class III-IV echocardiography parameters of LV: ejection fraction less than 40%, end-diastolic volume is more than 200 ml. Perfusion and function disorders were estimated with use of ECG-gated single photon emission computed tomography (SPECT).

Results: in 48% of cases 6-minute walk test increased more than 150%; NYHA class decreased by 2 classes (group 1). In 52% cases 6-minute walk test increased less than 50% and the NYHA class decreased on 1 class or did not change (group 2). Comparison of initial LV condition and clinical effect revealed following conformities. The revascularization effect is limited not to extent of coronary blood flow recovery, but first of all a cardiac muscle condition, the quantitative relation of the functioning myocardium and a focal cardiosclerosis. Thus, critical size to define the favorable forecast of revascularization is perfusion disorder more than a half of LV and kinetics disorder more than a third of cardiac muscle volume. Prevalence of a cardiosclerosis over the functioning myocardium limits clinical effect of a revascularization and growth of a functional reserve.

Conclusion: degree of initial LV myocardium perfusion and movement disorders at patients with severe ischemic heart failure is the key indicator, influencing clinical efficiency of coronary intervention

References

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Abstract:

Aim: was to assess dynamics of strain (S) and strain rate (SR) of longitudinal, circular and radial fibers in patients with left ventricular (LV) aneurysm (LVA) before and in early stages after coronary artery bypass graft (CABG) using Velocity Vector Imaging.

Material and methods: in 270 segments LV in patients with LVA, S and SR of LV fibers was analyzed before and after CAB. Also analysis of S and SR was performed in patients with CABG and plastic of the LV (group 1, 144 segments) and in the group with CABG without plastic of the LV (group 2, 126 segments).

Results: a function of longitudinal, circular and radial fibers after CABG has improved in all patients. Only SR of radial fibers reached normal. In group 1 was received the positive dynamics from the longitudinal S and SR, and SR circular and radial fibers. In group 2 indicators of function of longitudinal and circular fibers remained without negative dynamics, but positive dynamics is observed only from the SR of the radial fibers. The SR of radial fibers in both groups was normalized.

Conclusion: improvement of LV function in all patients is due to the group I. It is important to study the LV function in patients with LVA depending on the type of surgery.

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