Abstract:

Introduction: half-year data on results of using new domestic NanoMed devices for closing atrial septal defects (ASD) were obtained. The occluder is a nitinol self-expanding and self-centering double disc device with a polyester membrane.

Aim: was to evaluate the safety and efficacy of a new domestic occluder for closing of atrial septal defect in a small group of patients over a 6-month follow-up period.

Material and methods: four pediatric patients underwent closure of atrial septal defects with domestic NanoMed occluders. Clinical examination and transthoracic echocardiography were performed at 24 hours, 1, 3, and 6 months. Endpoints included technical success of intervention, efficacy and safety of the procedure at follow-up instrumentation and physical examination.

Results: the average age of patients was 5,2 years (range 4 to 7 years). Mean ASD diameters and device waist sizes were 11,9 ± 1,2 mm and 13,7 ± 1,2 mm and 13,7 ± 1,2 mm, respectively. Technical and procedural success achieved in 100% of cases. During the six-month follow-up, no adverse events and residual flows were identified.

Conclusion: initial half-year data on the absence of adverse events and residual flows indicate the safety and effectiveness of the use of NanoMed occluders.

References

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https://doi.org/10.1016/j.jacc.2018.08.1028

2.     Pettersen MD, Du W, Skeens ME, Humes RA. Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. Journal of the American Society of Echocardiography. 2008; 21(8): 922-934.

https://doi.org/10.1016/j.echo.2008.02.006

3.     Gillespie MJ, Javois AJ, Moore P, et al. Use of the GORE CARDIOFORM septal occluder for percutaneous closure of secundum atrial septal defects: results of the multicenter U.S. IDE trial. Catheterization and Cardiovascular Interventions. 2020; 95(7): 1296-1304.

https://doi.org/10.1002/ccd.28814

4.     Sharifi M, Burks J. Efficacy of clopidogrel in the treatment of post-ASD closure migraines. Catheter Cardiovasc Interv. 2004; 63: 255.

https://doi.org/10.1002/ccd.20144

Abstract:

Chemodectomas are rare, in most cases, benign neoplasms. They originate from the chemoreceptor cells of the carotid glomus in the bifurcation of the carotid artery. Chemodectoma treatment is surgical. Classical removal of the tumor carries a high risk of damage of arteries and nerves. We present a case report of high localization (C1) carotid chemodectoma removal in a hybrid operating room. Tumor was successfully removed after selective embolization of chemodectoma with protection of distal flow of the internal carotid artery. This approach helped to minimize intraoperative blood loss, as well as to shorten time of intervention.

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Abstract:

Currently, endovascular correction has become the method of choice in most cases of secondary atrial septal defects.

The obvious superiority lies in low trauma, a decrease in the incidence of early complications, atrial flutter and fibrillation, systemic thromboembolism, ischemic stroke, and all-cause mortality.

We present the initial experience of using new occluders for ASD closure.

References

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5.     Регистрационное удостоверение на медицинское изделие от 30 марта 2020 года № РЗН 2020/9850: «Окклюдер кардиологический «NanoMed» по НАЕФ.942511.015 ТУ.

Registration certificate for medical device, March 30, 2020 No. RZN 2020/9850: «NanoMed cardiological occluder» ac. to NAEF.942511.015 [In Russ].

6.     Базылев В.В., Шматков М.Г., Пьянзин А.И., Морозов З.А. «Отдаленные результаты применения отечественных коронарных стентов с биоинертным углеродным покрытием «Наномед». Журнал Диагностическая и интервенционная радиология. 2020; 14(1); 47-54.

Bazylev VV, Shmatkov MG, Pianzin AI, Morozov ZA. Long-term results of using domestic coronary stents with bioinert carbon coating, «Nanomed». Journal Diagnostic & interventional radiology. 2020; 14(1); 47-54 [In Russ].

https://doi.org/10.25512/DIR.2020.14.1.05

7.     Базылев В.В., Шматков М.Г., Морозов З.А. «Сравнительные результаты использования коронарных стентов с лекарственным покрытием «НаноМед» и Orsiro. Журнал Диагностическая и интервенционная радиология. 2019; 13(4); 21-26.

Bazylev VV, Shmatkov MG, Morozov ZA. Comparison of results of the use of coronary stents with drug eluting, «Nanomed» and Orsiro. Journal Diagnostic & interventional radiology. 2019; 13(4); 21-26 [In Russ].

https://doi.org/10.25512/DIR.2019.13.4.02

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9.     Aytemir K, Oto A, Ozkutlu S, et al. Early-midterm follow-up results of percutaneous closure of the interatrial septal defects with occlutech figulla devices: a single center experience. J Interv Cardiol. 2012; 25: 375-381.

10.   Haas NA, Happel CM, Soetemann DB, et al. Optimal septum alignment of the Figulla(R) Flex occluder to the atrial septum in patients with secundum atrial septal defects. EuroIntervention. 2016: 11(10):1153-60.

https://doi.org/10.4244/EIJY14M12_09

11.   Roymanee S, Promphan W, Tonklang N, et al. Comparison of the Occlutech (R) Figulla (R) septal occluder and Amplatzer (R) septal occluder for atrial septal defect device closure. Pediatr Cardiol. 2015; 36: 935-941.

12.   Sharifi M, Burks J. Efficacy of clopidogrel in the treatment of post-ASD closure migraines. Catheter Cardiovasc Interv. 2004; 63: 255.

Abstract:

Aim: was to determine the influence of blood plasma fibrinogen level on results of the left main coronary artery stenting.

Material and methods: clinical, laboratory and angiographic parameters of 819 patients after elective stenting of the unprotected left main coronary artery were used. The end-point was target lesion failure (TLF), including adverse events as repeated revascularization of the target lesion (TLR), myocardial infarction (MI) and death from cardiac causes.

Results: in 5 years follow-up period, end-point was achieved in 158 cases (19,3%). Independent predictors of TLF were: SyntaxScore > 32 (HR 1,089 95% CI 1,029-1,153, p = 0,003), creatinine level (HR 1,009 95% CI 1,004-1,013, p=0,001) and fibrinogen level (HR 1,4 95% CI 1,169-1698, p=0001). According to results of the Kaplan-Meier analysis, the cumulative probability of the TLF was higher in patients with fibrinogen values greater than 3,48 g/L (log-rank 0,001).

Conclusion: blood plasma fibrinogen level was an independent predictor of the TLF after left main coronary artery stenting. Increase in the level of blood fibrinogen for each 1 g/L led to an increase in the risk of TLF by 1,4 times per month.

References 

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Abstract

Introduction: article presents the first experience and long-term results of using domestic coronary balloon-expandable stents with a bioinert carbon coating, «Nanomed».

Aim: was to evaluate long-term results of using domestic coronary balloon-expandable stents with bioinert linear chain carbon coating (BLCCC), «Nanomed».

Materials and methods: the study included 387 patients, suffering from coronary heart disease, who underwent endovascular myocardial revascularization from 2016 to 2018, with implantation of coronary balloon-expandable stents with BLCCC by the Nanomed company, Penza. The control group included 320 patients who underwent endovascular myocardial revascularization with implantation of coronary balloon-expandable cobalt-chromium stents «MSure Cr» of the company «Multimedics», during the same period. A comparative estimation of long-term results was carried out on the basis of a study of the overall frequency of repeated myocardial revascularization; repeated interventions on the target vessel; the frequency of interventions on other coronary arteries with the progression of atherosclerosis; long-term survival rates.

Results: in the long-term period, the overall probability of absence of repeated revascularization in 47 months after PCI was 78,3 ± 2.1% and 72,1 ± 2.4% in the «Nanomed» BLCCC and «MSure Cr» groups, respectively. There was no statistically significant difference between groups (Log. Rank=0,77). However, the incidence of restenosis in the stent was statistically significantly higher in the «MSureCr» group. (p = 0,027). The overall probability of survival in 47 months after surgery was 98,2±2,4% and 98,1±2.6% in groups 1 and 2, respectively. No statistically significant difference between groups was found (Log. Rank=0,4).

Conclusions: 1. The use of a coronary balloon-expandable stent with a BLCCC, Nanomed for endovascular myocardial revascularization is an effective treatment in patients with coronary heart disease.

2. Long-term results of using bioinert carbon-coated stents, Nanomed and MSureCr stents were comparable in terms of absence of myocardial re-revascularization procedures due to relapse of the angina pectoris and survival time of up to 47 months. However, the incidence of restenosis in a stent with a bioinert carbon coating, Nanomed was statistically significantly lower.

References

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3.     Morice M, Urban P, Greene S, Schuler G, Chevalier B. Why are we still using Coronary Bare-Metal Stents? JACC 2013;61;1122-3.

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6.     Carrie D, Lefevre T, Cherradi R, et al. Does Carbofilm coating affect in-stent intimal proliferation? A randomized trial comparing Rx multi-link penta and TecnicCarbostent Stents: SIROCCO Trial. J Interv Cardiol. 2007; 20(5):3818.

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10.   Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R. Pathology of drug-eluting stents in humans: Delayed healing and late thrombotic risk. J. Am. Coll. Cardiol. 2006; 193-202.

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12.   Sarno G, et al., Lower risk of stent thrombosis and restenosis with unrestricted use of 'newgeneration' drug-eluting stents: a report from the nation wide Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Eur Heart J. 2012;  33(5): 606-13.

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Abstract

Aim: was to compare annual results of the use of stents with drug eluting - «NanoMed» and Orsiro.

Material and methods: in a randomized prospective study, an analysis of clinical and angiographic data of 1040 patients after stenting of coronary arteries with the observation period of 12 months was performed. The study and control groups randomly included 520 patients with implanted stents «NanoMed» and Orsiro.

Results: main initial clinical demographic and angiographic indicators did not statistically significantly differ. The primary endpoint (TLF - target lesion failure) was achieved in 6.5 and 5.9% in «NanoMed» and Orsiro groups, respectively (p = 0.7). Target lesion revascularization (TLR) was performed in study and control groups, respectively, in 1.7 versus 1.2% of cases (p = 0.4).

Conclusion: thus, in a comparative analysis of the use of stents «NanoMed» and Orsiro for a period of 12 months - no statistically significant difference was revealed.

References

1.     El-Hayek G, Bangalore S, Casso Dominguez A, et al. Meta-Analysis of Randomized Clinical Trials Comparing Biodegradable Polymer Drug-Eluting Stent to Second-Generation Durable Polymer Drug-Eluting Stents. JACC Cardiovasc. Interv. 2017; 10(5): 462-473.

2.     Joner M, Finn A, Farb A, et al. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J. Am. Coll. Cardiol. 2006; 48: 193-202.

3.     Sarno G, Lagerqvist B, Fmbert O, et al. Lower risk of stent thrombosis and restenosis with unrestricted use of 'newgeneration' drug-eluting stents: a report from the nation wide Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Eur. Heart J. 2012; 33(5): 606-613.

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Abstract:

Aim: was to identify risk factors of early adverse cerebral events after carotid artery stenting anc endarterectomy

Materials and methods: 908 patients who underwent isolated carotid stenting (N = 522) and carotid endarterectomy (N = 386) were included in this retrospective analysis. Patients with simultaneous cardiac surgery and patients with symptomic stenosis of CA were excluded from research. The primary end point was ipsilateral perioperative ischemic stroke, proved by neurologist and CT/MRI data. To identify predictors, multivariate regression was used, with factors that could influence endovascular and surgical methods of treatment.

Results: patients from two groups were similar in main clinical and demographic characteristics. There were no deaths and cerebral hemorrhagic complications. The stroke rate in the endovascular and surgical groups was 1.7% and 1.04% respectively (p = 0.5). The total rate of strokes and transitory ischemic attack (TIA) using two methods was 1.4%. The TIA rate was higher in the endovascular group without statistically difference (1.3% vs. 0.3%, p = 0.1). The regression analysis showed that predictor of the adverse cerebral events was the degree of carotid artery stenosis in endovascular group (OR 1.318, 95% CI: 1.131-1.535, p <0.001). There were no any predictive factors of TIA or stroke in the surgical group.

Conclusions: the independent predictor of early TIA and stroke in endovascular group, unlike endarterectomy, was the degree of carotid stenosis.

References

1.      Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, et al. 2011 ASA/ACCF/AHA/AANN/ AANS/ACR/ ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease:executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force of Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventionalSurgery, Society for Vascular Medicine, and Society for VascularSurgery. Developed in collaboration with the American Academyof Neurology and Society of Cardiovascular Computed Tomography Catheter Cardiovasc Interv 2013; 81:76-123.

2.      Sakai N, Yamagami H, Matsubara Y et al. Prospective registry of carotid artery stenting in Japan: investigation on device and antiplatelet for carotid artery stenting. J Stroke Cerebrovasc Dis.2014; 23: 1374-1384.

3.      Jhang K, Huang J, NforIs O et al. Is Extended Duration of Dual Antiplatelet Therapy After Carotid Stenting Beneficial? Medicine 2015; 94:40.

4.      Mo D, Wang B, Ma N, et al. Comparative outcomes of carotid artery stenting for asymptomatic and symptomatic carotid artery stenosis: a single-center prospective study. J Neurointerv Surg. 2016; 8(2): 126-129.

5.      Bonati LH, Dobson J, Featherstone RL, et al. Longterm outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the Internation al Carotid Stenting Study (ICSS) randomised trial. Lancet. 2015; 385: 529-538.

6.      Stingele R, Berger J, Alfke K, et al. Clinical and angiographic risk factors for stroke and death within 30 days after carotid endarterectomy and stent-protected angioplasty: a subanalysis of the SPACE study. Lancet Neurol 2008; 7: 216-222.

7.      Howard VJ, Lutsep HL, Mackey A, et al. Influence of sex on outcomes of stenting versus endarterectomy: a subgroup analysis of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Lancet Neurol 2011; 10: 530-537.

8.      Setacci C, Chisci E, Setacci F, et al. Siena carotid artery stenting score: a risk modeling study for individual patients. Stroke 2010; 41: 1259-1265.

9.      AbuRahma AF, Alhalbouni S, Abu-Halimah S, et al. Impact of chronic renal insufficiency on the early and late clinical outcomes of carotid artery stenting using serum creatinine vs glomerular filtration rate. J Am Coll Surg 2014; 218: 797- 805.

10.    Kofoed SC, Wittrup HH, Sillesen H, Nordestgaard BG. Fibrinogen predicts ischaemic stroke and advanced atherosclerosis but not echolucent, rupture-prone carotid plaques: the Copenhagen City Heart Study. Eur Heart J 2003;24:567-576.

11.    Dosa E, Rugonfalvi-Kiss S, Prohaszka Z, Szabo A, Karadi I, Selmeci L, et al. Marked decrease in the levels of two inflammatory markers, hs-C-reactive protein and fibrinogen in patients with severe carotid atherosclerosis after eversion carotid endarterectomy. Inflamm Res 2004; 53:631-635.

12.    Maresca G, Di Blasio A, Marchioli R, Di Minno G. Measuring plasma fibrinogen to predict stroke and myocardial infarction: an update. Arterioscler Thromb Vasc Biol 1999; 19:1368-1377.

13.    Gray WA,Yadav JS, Verta P, et al. The CAPTURE registry: predictors of outcomes in carotid artery stenting with embolic protection for high surgical risk patients in the early post-approval setting. Catheter Cardiovasc Interv 2007; 70: 1025-1033.

14.    Theiss W, Hermanek P, Mathias K, et al. Predictors of death and stroke after carotid angioplasty and stenting: a subgroup analysis of the Pro-CAS data. Stroke 2008; 39: 2325-2330.

15.    Chaturvedi S, Matsumura JS, Gray W, et al. Carotid artery stenting in octogenarians: periprocedural stroke risk predictor analysis from the multicenter Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events (CAPTURE 2) clinical trial. Stroke 2010; 41: 757-64.

16.    Mathur A, Roubin GS, Iyer SS, et al. Predictors of stroke complicating carotid artery stenting. Circulation 1998; 97: 1239-1245.

17.    Nicolaides AN, Kakkos SK, Kyriacou E, Griffi n M, Sabetai M, Thomas DJ, et al. Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) Study Group. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification. J Vasc Surg 2010;52:1486-1496.

18.    Obeid T, Arnaoutakis DJ, Arhuidese I, et al. Poststent ballooning is associated with increased periprocedural stroke and death rate in carotid artery stenting. J Vasc Surg 2015; 62: 616-623.

19.    Aronow HD, Gray WA, Ramee SR, et al. Predictors of neurological events associated with carotid artery stenting in high-surgical-risk patients. Circ Cardiovasc Interv 2010; 3: 577-584.

Abstract:

Aim: was to establish methods of coronary artery bypass graft (CABG) with use of internal thoracic artery (ITA), that influenced high risk of continued diaphragmatic dysfunction in early post-operative period, on the base of analysis of dynamics of diaphragmatic dysfunction after operation.

Materials and methods: the retrospective study included 880 patients in the early period after CABG with use of ITA. The mobility of diaphragm domes was estimated on 2,8±0,88 day after the surgery, when transferred from the intensive care unit to the in-patient department and again on 7,7±1,9 day when transferred to the rehabilitation department. Patients were divided into 3 groups. The first group with normal diaphragm mobility with an initial study of 529(60,1%) patients. The second group with diaphragmatic dysfunction in the initial study and the restored mobility of the diaphragm in a re-examination of 249(28,3%) patients. The third group with diaphragmatic dysfunction, which persists in the re-examination of 102(11,6%) patients. The criterion for diaphragmatic dysfunction was the amplitude of the diaphragm's movement ess than 10 mm. Using the model of logistic regression, the influence of the CABG methods on the probability of maintaining diaphragmatic dysfunction at the end of the early postoperative period was determined. Two CABG methods were included in the model: «in situ» and autograft.

Results: in the primary study, 39,9% of patients had diaphragmatic dysfunction, 21,1% left-sided, 8,0% right-sided, and 10,8% bilateral. The prevalence of diaphragmatic dysfunction during the early postoperative period decreases threefold, from 39,9% to 11,5%, and was persisted more often as a unilateral lesion: left-sided in 7,2% of patients or right-sided in 3,4%, Less often, bilateral dysfunction persists in 0,9% of patients. Restoration of the function of the diaphragm during repeated examination was observed in 71,2% of cases of initial dysfunction. A different effect was established on the persistence of unilateral and bilateral diaphragmatic dysfunction by the end of the early postoperative period, depending on methods of CABG with use of ITA and their combination. High likelihood conservation diaphragmatic dysfunction by the right harvest of ITA was observed after bypass «in situ» (OR 4.4; CI 2,2-8,9) and by the harvest of ITA left after bypass graft (OR 4.1; CI 1,6-10,6). Other methods of grafting either did not have an effect on the preservation of dysfunction on the part of the ITA harvest, or the effect was traced, but was statistically insignificant.

Conclusion: dysfunction of the diaphragm acquired after CABG with use of ITA is reversible. During the early postoperative period, 71,2% of patients undergo full restoration of diaphragm mobility, the prevalence of diaphragmatic dysfunction decreases three-fold, the frequency of bilateral diaphragm dysfunction decreases by 10 times. Methods of CABG with use of ITA, «insitu» and autograft, affect the likelihood of the dysfunction of the diaphragm retained during the early postoperative period by surgical manipulation. Results of the study indicate that chances of maintaining diaphragmatic dysfunction were 4,4 times higher by grafting the right ITA «in .situ» and 4,1 times by grafting the left ITA with a graft. While the likelihood of maintaining diaphragmatic dysfunction was low by grafting the right ITA with a graft and was absent from the grafting of the left ITA «in situ».

References

1.      Paramonova T.I., Vdovkin A.V., Pal'kova V.A. Factors, influencing the development of diaphragmatic dysfunction in the early postoperative period after cardiac surgery. Diagnosticheskaya I interventsionnaya radiologia. 2016; 10(2):11-16.

2.      Canbaz S, Turgut N, Halici U, et al. Electrophysiological evaluation of phrenic nerve in-jury during cardiac surgery - a prospective, controlled, clinical study. BMC Surgery. 2004, 4:2

3.      Deng Y Byth K, Paterson HS. Phrenic nerve injury associated with high free right internal mammary artery harvesting. Ann Thorac Surg. 2003; 76(2):459-463

4.      Bazylev V.V., Paramonova T.I., Vdovkin A.V., i soavt. Ocenka faktorov, vliyayushchih na razvitie dispnoeh v rannem posleoperacionnom periode posle kardiohirurgicheskih vmeshatel'stv. [Factors affecting the development of dyspnea in the early postoperative period after cardiac surgery] Diagnosticheskaya i intervencionnaya radiologiya. 2016; 10(4):19-27.

5.      Bonacchi M, Prifti E, Giunti G, et al. Respiratory dysfunction after coronary artery bypass grafting employing bilateral internal mammary arteries: the influence of intact pleura. Eur J Cardiothorac Surg. 2001; 19:827-833.

6.      Matsumoto M., Konishi Y, Miwa S., et al. Effect of different methods of internal thoracic artery harvest on pulmonary function. Ann Thorac Surg. 1997; 63: 653-655.

7.      Uzun K, Kara H, Ugurlu D. The Effects Of Internal Mammary Artery Harvesting Techniques On Pulmonary Functions. Ko§uyolu Kalp Dergisi. 2011; 14(3):76-78.

8.      Diehl JL, Lofaso F, Deleuze P, et al. Clinically relevant diaphragmatic dysfunction after cardiac operations. J Thorac Cardiovasc Surg. 1994; 107:487-498

9.      Bazylev V.V., Paramonova T.I., Vdovkin A.V. Analiz polozheniya i podvizhnosti diafragmy u vzroslyh s normal'noj funkciej legkih do i posle kardiohirurgicheskih operacij. [Analysis of position and mobility of the diaphragm in adults with normal lung function before and after cardiac surgery.] Luchevaya diagnostika i terapiya. 2017;(1):53-63.

10.    Davison A., Mulvey D. Idiopathic diaphragmatic weakness. BMJ 1992; 304:492-494

11.    McCool F.D., McCool G.E. Dysfunction of the Diaphragm. N Engl J Med. 2012; 366:932-942

12.    Kim WY Suh HJ, Hong SB, et al. Diaphragm dysfunction assessed by ultrasonography: Influence on weaning from mechanical ventilation. Critical Care Medicine. 2011; 12:2627-2630.

13.    Bazylev V.V., Nemchenko E.V., Karnahin V.A., i soavt. Floumetricheskaya ocenka koronarnyh shuntov v usloviyah iskusstvennogo krovoobrashcheniya i na rabotayushchem serdce. [Flowmetric estimation of coronary grafts in conditions of extracorporeal circulation and on a working heart.] Angiologiya i sosudistaya hirurgiya. 2016; 22(1):67-72.

14.    Rankin JS, Tuttle RH, Wechsler AS. et al. Techniques and benefit of multiple internal mammary artery bypass at 20 year of follow up. Ann Thorac Surg. 2007; 83:1008-1015.

15.    Buxton BF, Tatoulis J, Fuller JA. The right internal thoracic artery: the forgotten conduit - 5,766 patients and 991 angiograms. The Annals of Cardiothoracic Surgery. 2011; 92: 9-17.

16.    Lytle BW, Blackstone EH, Sabik JF. et al. The effect of bilateral internal thoracic artery grafting on survival during 20 postoperative years. Ann Thorac Surg 2004;78(6):2005-2014.

17.    Tripp HF., Sees DW, Lisagor P.G, et al. Is phrenic nerve dysfunction after cardiac surgery related to internal mammary harvesting? J Card Surg. 2001, 16(3):228-231

18.    Calafiore AM, Di Giammarco G., Teodori G, et al. Bilateral internal thoracic artery grafting with and without cardiopulmonary bypass: six-year clinical outcome. J Thorac Cardiovasc Surg. 2005; 130(2):340—345.

19.    Cygel'nikov S.A. Vnutrennyaya grudnaya arteriya v hirurgicheskom lechenii ishemicheskoj bolezni serdca: varianty i taktika ispol'zovaniya, rezul'taty. [Internal thoracic artery in the surgical treatment of ischemic heart disease: options and tactics of use, results.] Avtoreferat Dis. dok. med. nauk. M., 2010; 49.

20.    Buxton BF, Ruengskulrach P, Fuller J, et al. The right internal thoracic artery graft - benefits of grafting the left coronary system and native vessels with a high-grade stenosis. The European Journal of Cardio-Thoracic Surgery. 2000; 18:255-261.

21.    Bazylev V.V., Nemchenko E.V., Pavlov A.A., i soavt. Sravnitel'nye rezul'taty revaskulyarizacii bassejna pravoj koronarnoj arterii s ispol'zovaniem bimammarnogo Y- grafta i autoveny. [Comparative results of revascularization of right coronary artery basin using bimammary Y-graft and autovein.] Grudnaya i serdechno-sosudistaya hirurgiya. 2014; 5:11-18.

22.    Vecherskij YU.YU., Andreev S.L., Zatolokin V.V. Taktika ispol'zovaniya pravoj vnutrennej grudnoj arterii «in situ» pri koronarnom shuntirovanii. [Tactics of using the right internal thoracic artery «in situ» in CABG surgery.] Angiologiya isosudistaya hirurgiya. 2015; 1(21):148-154.

23.    O'Brien JW, Johnson SH, VanSteyn SJ, et al. Effects of internal mammary artery dissection on phrenic nerve perfusion and function. Ann Thorac Surg. 1991; 52: 182-188.

24.    Sharma AD, Parmley CL, Sreeram G, et al. Peripheral nerve injuries during cardiac surgery: risk factors, diagnosis, prognosis, and prevention. Anesth Analg. 2000; 91(6):1358

25.    Wilcox PG, Pardy RL. Diaphragmatic weakness and paralysis. Lung. 1989; 167:323-341

26.    Buxton BF, Hayward PA. The art of arterial revascularization - total arterial revascularization in patients with triple vessel coronary artery disease. The Annals of Cardiothoracic Surgery. 2013; 2: 543-551.

27.    Paterson HS, Naidoo R., Byth K, et al. Full myocardial revascularization with bilateral internal mammary artery Y grafts. The Annals of Cardiothoracic Surgery. 2013; 2: 444-452.

28.    Akchurin R. S., Shiryaev A. A., Brand YA. B., i soavt. Hirurgiya koronarnyh arterij - krajnosti i algoritmy revaskulyarizacii. [Surgery of coronary arteries - extremes and algorithms of revascularization.] Grudnaya i serdechno-sosudistaya hirurgiya. 2001; 2:13-17

Abstract:

Aim: was to assess chances of the development of postoperative diaphragmatic dysfunction (DD), depending on methods of coronary artery bypass graft (CABG), by estimation the probability of development of DD according to the side of internal thoracic artery (ITA) harvest.

Materials and methods: evaluation of the mobility of domes of the diaphragm in the early perioc after 3051 CABG operations (with use of ITA) was made. Control group included patients with normal mobility of the diaphragm. Study group included patients with right-sided, left-sided and bilateral DD. Using a logistic regression model we evaluated the influence of the method of CABG (with use of ITA) in the development of DD from the side of the ITA harvest. The model included two ways of CABG - «in situ» and autograft.

Results: there are differences in chances of development of unilateral and bilateral DD, depending on the method of CABG (with use of ITA) and combinations thereof. High possibility of developing DD after CABG with right ITA was observed after CABG «in situ» (OR 5,4; CI 4,3-6,8), and smaller after CABG with ITA autograft (OR 1,8; CI 1,4-2,3). High possibility of DD was observed after CABG with left ITA autograft (OR 3,5; CI 2,2-5,6); after CABG «in situ», there was no DD.

Conclusion: methods of CABG using ITA, «in situ» and autograft, differently affect the mobility of the diaphragm from the side of surgical procedure. Results of the study indicate a high probability of DD after CABG with left ITA autograft and right ITA «in situ». It is established that possibility of DD was low in case of CABG with right ITA as autograft and was absent in left ITA «in situ».

References

1.      Bazylev V.V., Paramonova T.I., Vdovkin A.V. Analysis of position and mobility of the diaphragm in adults with normal lung function before and after cardiac surgery. Luchevaya diagnostika i terapiya. 2017;(1):53-63. [In Russ].

2.      Paramonova T.I., Vdovkin A.V., Pal'kova V.A. Factors, influencing the development of diaphragmatic dysfunction in the early postoperative period after cardiac surgery. Diagnosticheskaya i intervencionnaya radiologiya. 2016; 10(2):11-16. [In Russ].

3.      Canbaz S., Turgut N., Halici U., et al. Electrophysiological evaluation of phrenic nerve injury during cardiac surgery - a prospective, controlled, clinical study. BMC Surgery. 2004, 4:2

4.      Deng Y, Byth K., Paterson H.S. Phrenic nerve injury associated with high free right internal mammary artery harvesting. Ann Thorac Surg. 2003; 76(2):459-463.

5.      Bazylev V.V., Paramonova T.I., Vdovkin A.V., et al. Factors affecting the development of dyspnea in the early postoperative period after cardiac surgery. Diagnosticheskaya i intervencionnaya radiologiya. 2016; 10(4):19-27. [In Russ].

6.      Bonacchi M, Prifti E, Giunti G, et al. Respiratory dysfunction after coronary artery bypass grafting employing bilateral internal mammary arteries: the influence of intact pleura. Eur J Cardiothorac Surg. 2001; 19:827-833.

7.      Matsumoto M., Konishi Y, Miwa S., et al. Effect of different methods of internal thoracic artery harvest on pulmonary function. Ann Thorac Surg. 1997; 63:653-655.

8.      Uzun K., Kara H., Ugurlu D. The Effects Of Internal Mammary Artery Harvesting Techniques On Pulmonary Functions. Ko§uyolu Kalp Dergisi. 2011; 14(3):76-78.

9.      Ozkara A., Hatemi A., Mert M.,et al.The effects of internal thoracic artery preparation with intact pleura on respiratory function and patients' early outcomes. Anadolu Kardiyol Derg. 2008; 8: 368-373.

10.    Bazylev V.V., Nemchenko E.V., Karnahin V.A.. et al. Flowmetric estimation of coronary bypass grafts in conditions of extracorporeal circulation and on a working heart.] Angiologiya i sosudistaya hirurgiya. 2016;22(1): 67-72. [In Russ].

11.    Rankin J.S., Tuttle R.H., Wechsler A.S. et al. Techniques and benefit of multiple internal mammary artery bypass at 20 year of follow up. Ann Thorac Surg. 2007; 83:1008-1015.

12.    Buxton B.F., Tatoulis J., Fuller J.A. The right internal thoracic artery: the forgotten conduit - 5,766 patients and 991 angiograms. The Annals of Cardiothoracic Surgery. 2011; 92: 9-17.

13.    Lytle B.W., Blackstone E.H., Sabik J.F. et al. The effect of bilateral internal thoracic artery grafting on survival during 20 postoperative years. Ann Thorac Surg 2004;78(6):2005-2014

14.    Tatoulis J. Total arterial coronary revascularization - patient selection, stenoses, conduits, targets. The Annals Cardiothoracic Surgery. 2013;2:499-506.

15.    O'Brien J.W., Johnson S.H., VanSteyn S.J., et al. Effects of internal mammary artery dissection on phrenic nerve perfusion and function. Ann Thorac Surg. 1991; 52: 182-188.

16.    Sharma A.D., Parmley C.L., Sreeram G., et al. Peripheral nerve injuries during cardiac surgery: risk factors, diagnosis, prognosis, and prevention. Anesth Analg. 2000; 91(6):1358

17.    Calafiore A.M., Di Giammarco G., Teodori G., et al. Bilateral internal thoracic artery grafting with and without cardiopulmonary bypass: six-year clinical outcome. J Thorac Cardiovasc Surg. 2005; 130(2):340-345.

18.    Cygel'nikov S.A. Internal thoracic artery in the surgical treatment of ischemic heart disease: options and tactics of use, results. Avtoreferat Dis. dok. med. nauk. M., 2010; 49. [In Russ].

19.    Buxton B.F., Ruengskulrach P., Fuller J., et al. The right internal thoracic artery graft - benefits of grafting the left coronary system and native vessels with a high-grade stenosis. The European Journal of Cardio-Thoracic Surgery. 2000; 18: 255-261.

20.    Bazylev V.V., Nemchenko E.V., Pavlov A.A., et al. Comparative results of revascularization of right coronary artery basin using bimammary Y-graft and autovein. Grudnaya i serdechno-sosudistaya hirurgiya. 2014; 5: 11-18. [In Russ].

21.    Vecherskij YU.YU., Andreev S.L., Zatolokin V.V. Tactics of using the right internal thoracic artery «in situ» in CABG surgery.] Angiologiya i sosudistaya hirurgiya. 2015;1(21):148-154. [In Russ].

22.    Buxton B.F., HaywardPA. The art of arterial revascularization - total arterial revascularization in patients with triple vessel coronary artery disease. The Annals of Cardio-thoracic Surgery. 2013;2:543-551.

23.    Paterson H.S., Naidoo R., Byth K., et al. Full myocardial revascularization with bilateral internal mammary artery Y grafts. The Annals of Cardiothoracic Surgery. 2013;2:444-452.

24.    Akchurin R. S., Shiryaev A. A., Brand YA. B., et al. Surgery of coronary arteries - extremes and algorithms of revascularization. Grudnaya i serdechno-sosudistaya hirurgiya. 2001; 2:13-17. [In Russ]. 

Abstract:

Aim: was to assess the consistency of measurements of anatomic and functional parameters performed with EchoCG and MRI and to determine the possibility of MRI to visualize the coaptation of valve leaflets after reconstruction of the aortic valve (AV) using the Ozaki technique.

Material and methods: the study included 124 patients who underwent MRI of the heart anc transthoracic EchoCG, 9,3±4,0 days after the Ozaki operation. With EchoCG and MRI, EDV and LV EF were calculated. Dopplerography determined the area of AV opening and the transaortal pressure gradient. At MRI, the area of AV opening was planetically measured, and the transoortal pressure gradient was calculated from results of phase contrast study To assess the consistency of measurement results, the Blend-Altman method was used.

Results: mean values obtained with EchoCG and MRI were statistically significantly different (p<0,001) only when measuring LV EDV The greatest accordance between measurements of EchoCG and MRI was observed in the evaluation of the transaortal pressure gradient (0,04±3,7 mm Hg). Less coordinated were measurements of the opening area of AV (0,22±0,79 cm2) and LV EF (0,22±8,9%). Less consistency was in measurement of EDV (26,4±33,0 ml). The mean value of the difference was statistically significantly different from zero when measuring the opening area of AV (p=0,180) and the transaortal pressure gradient (p=0,120). The article presents 5 clinical examples of visual evaluation of leaflets coaptation after AV reconstruction by the Ozaki method.

Conclusions: differences in consistency in the assessment of the opening area of the AV and the transaortal pressure gradient in echocardiography and MRI are not clinically significant, indicating that these measurement methods can be used interchangeably after AV reconstruction using the Ozaki technique.

Results of measurements of EDV size and LV EF in EchoCG and MRI are less consistent and not interchangeable, therefore, measurement results should be interpreted in the context of the specific method

MRI should be a part of the diagnostic algorithm after Ozaki surgery, but its use in the early postoperative period may be limited to cases of poor quality or inconsistent Echocardiography

References

1.      Salem M. A.; Abd El-Razek M. A.; Bassiouny M. I. et al. Diagnostic Value of Cardiac MRI in Aortic Valve Stenosis in Comparison with Echocardiography. Med J Cairo Univ., 2016; 84 (2):271-278.

2.      Sondergaard L., Hildebrandt P., Lindvig K., et al. Quantification by magnetic resonance velocity mapping. Am Heart J., 1993; 26(5):156-1164.

3.      Bellenger N.G., Burgess M.I., Ray S.G. Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionucleide ventriculography and cardiovascular magnetic resonance. Are they interchangeable?. Eur Heart J., 2000; 21:1387-1396.

4.      Bellenger N.G., Francis J.M., Davies L.C. et al. Establishment and performance of a magnetic resonance cardiac function clinic. J Cardiovasc Magn Reson. 1999; 1(4):323-330.

5.      Bernard Y, Meneveau N., Boucher S. et al. Lack of agreement between left ventricular volumes and ejection fraction determined by two-dimensional echocardiography and contrast cineangiography in postinfarction patients. Echocardiography. 2001;18:113-122.

6.      Darasz K.H., Underwood S.R., Bayliss J. et al. Measurement of left ventricular volume after anterior myocardial infarction: comparison of magnetic resonance imaging, echocardiography, and radionuclide ventriculography. The Int J of Cardiovasc Imaging. 2002;18(2):135-142.

7.      Gardner B., Bingham S., Allen M. et al. Cardiac magnetic resonance versus transthoracic echocardiography for the assessment of cardiac volumes and regional function after myocardial infarction: an intrasubject comparison using simultaneous intrasubject recordings. The J of Cardiovasc ultrasound. 2009;7:38-44.

8.      Li C., Lossnitzer D., Katus H.A. et al. Comparison of left ventricular volumes and ejection fraction by monoplane cineventriculography, unenhanced echocardiography and cardiac magnetic resonance imaging. Int J Cardiovasc Imaging. 2012; 28(5):1003-1010.

9.      Malm S., Frigstad S., Sagberg E.; et al. Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography a comparison with magnetic resonance imaging. J Am Coll Cardiol. 2004; 44(5):1030-1035.

10.    Ozaki S. Pathophysiology of calcification of bioprosthetic heart valves: an experimental investigation. LeuvenUniversity Press. 2001;238.

11.    Ozaki S., KawaseI., Yamashita H., et al. A total of 404 cases of aortic valve reconstruction with glutaraldehyde-treated autologous pericardium. J. Thora Cardiovasc Surg. 2014; 147(1):301-306.

12.    Rossejkin E.V., Bazylev V.V., Batrakov P.A. i dr. Neposredstvennye rezul'taty protezirovanija stvorok aortal'nogo klapana autoperikardom po metodike Ozaki [Immediate results of aortic valve leaflets replacement with auto pericardium due to Ozaki technique]. Patobgija krovoobrashhenija i kardiohirurgija. 2016; 20(2):44-48 [ In Russ].

13.    Ozaki S., Kawase I., Yamashita H., et al. Aortic Valve Reconstruction Using Autologous Pericardium for Aortic Stenosis. Circ J. 2015; 79(7):1504-1510.

14.    Izgi C. MRI evaluation of aortic stenosis: flow evaluation. https://www.escardio.org/Education/PracticeTools/ EACVI-toolboxes/Valvular-Imaging/Atlas-of-valvular-imaging/Aortic-stenosis/MRI-evaluation-of-aortic- stenosis-flow-evaluation

15.    La Manna A., Sanfilippo A., Capodanno D. et al. Cardiovascular magnetic resonance for the assessment of patients undergoing transcatheter aortic valve implantation: a pilot study. J Cardiovasc Magn Reson. 2011;13: 82-90.

16.    Rajani R., Hancock J., Chambers J.B. The art of assessing aortic stenosis. Heart. 2012;98(4):14-22.

17.    Oosterhof T, Mulder B.J.M., Vliegen H.W. et al. Cardiovascular magnetic resonance in the follow-up of patients with corrected tetralogy of Fallot. American Heart J. 2006;151:265-272.

18.    Bazylev V.V., Paramonova T.I., Vdovkin A.V., Pal'kova V.A. Pri kakom razmere KDO u bol'nyh s sistolicheskoj disfunkciej levogo zheludochka predpochtitel'no vypolnenie magnitno-rezonansnoj tomografii [What dimensions of EDV in patients with systolic dysfunction of the left ventricle is preferable to perform MRI?.]. Diagnosticheskaja i intervencionnaja radiologija. 2017;11(2):30-37 [In Russ].

19.    Bazylev V.V., Paramonova T.I., Vdovkin A.V., Karpuhin V.G., Pal'kova V.A. Soglasovannost' JehoKG i MRT v ocenke mitral'noj regurgitacii i KDO u bol'nyh s dilataciej levogo zheludochka [Accordance of MRI and EchoCG in estimation of mitral regurgitation and EDV in patients with left ventricle dilatation]. Luchevaja diagnostika i terapija. 2017;1 (8): 64-68 [ In Russ].

 Abstract:

Aim: was to compare endothelialization of stents with permanent and biodegradable coatings at an early stage with help of optical coherence tomography (OCT).

Materials and methods: this study is a prospective, randomized trial that includes a comparative analysis of OCT data in patients after implantation of coronary stents with biodegradable (study group) and permanent coatings (control group). 98 patients were randomized 1:1 into 2 groups. After 3 months, 10 patients from each group - were randomized to conduct OCT.

Results: we analyzed OCT data of 10 studies in the biodegradable group (1,776 struts and 247 sections) and 10 studies in the permanent coating group (1562 struts and 226 sections). There were no differences in proportion of uncovered (8,9% vs. 8,5%, p=0,49) and non-exposed struts (1,6% vs. 1,3%, p=0,2). Thus, 98,4% of struts in study group and 98.7% in control group were endothelialized.

Conclusions: according to OCT data, similar results were obtained in both groups. After 3 months of observation in two groups, the overwhelming number of struts were endothelialized. At the early stage of observation, none of groups, achievement of endpoints was detected. 

References

1.     Mauri L., Kereiakes D., Yeh R. et al. Twelve or 30 Months of Dual Antiplatelet Therapy after Drug-Eluting Stents. N Engl J Med. 2014; 371:2155-2166.

2.     Authors/Task Force members , Windecker S., Kolh P., et al. ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35:2541-619.

3.     Kim S., Kim J.S., Shin D.H., et al. Comparison of early strut coverage between zotarolimus- and everolimus-eluting stents using optical coherence tomography. Am J Cardiol. 2013;111:1-5.

4.     Izumi D., Miyahara M., Sakai M., Fukuoka S. OCT- based comparison of early strut coverage between zotarolimus- and everolimus-eluting stents with second stent designs. Eurointervention. 2014;5;20.

5.     Ormiston J., Webster M., Stewart J. et al. First-inHuman Evaluation of a Bioabsorbable Polymer-Coated Sirolimus-Eluting Stent. JACC: Cardiovasc int 2013; 6(10): 1026-1034.

6.     Karjalainen P, Varho V., Nammas W. et al. Early Neointimal Coverage and Vasodilator Response Following Biodegradable Polymer Sirolimus-Eluting vs. Durable Polymer Zotarolimus-Eluting Stents in Patients With Acute Coronary Syndrome. Circulation Journal .2015;79(2): 360-367. 

Abstract:

Aim: was to reveal factors, influencing high cnance of dysfuntion of diaphragm domes in further patient examination by estimation of dynamics of acqired diaphragmatic dysfunction after different cardiac surgical interventions.

Material and methods: research included 642 patients after different cardiac surgical interventions. We estimated mobility of diaphragm domes at the moment of patients discharge from intensive care unit and secondly before transporting to rehabilitation center. All patients were devided into 3 groups. 1st group: patients with normal mobility of diaphragm at initial examination - 395 (61,5%). 2nd group - diaphragmatic dysfunction at initial examination and recovered mobility at further examination - 173 patients (26,9%). 3rd group - patients with diaphragmatic dysfunction at both stages of examination - 74 (11,5%). Criteria for diaphragmatic dysfunction - mobility amplitude of domes less than 10 mm. We estimated chances of extant dysfunction, under the influence of complex of clinical and surgical factors.

Results: at initial examination diaphragmatic dysfunction was revealed at 38,5%, left dome - 18,2%, right dome - 10,3%, bilateral dysfunction - 10,0%. At further examination diaphragmatic dysfunction persisted in 11,5% of patients, left-sided - 7,5%, right-sided - 3,9%, bilateral - in one case. Recovery of diaphragmatic function was achieved in 70% of initial dysfunction. High and statistically significant chances of extant dysfunction were evaluated only in case of unilateral separation of internal thoracic artery (ITA). Other surgical and clinical factors had no statistically sugnificant influence.

Conclusions: aquired diaphragmatic dysfunction after different cardiac surgical interventions ir 70% of cases is reversible. Recovery of diaphragm mobility was full. Prevalence of diaphragmatic dysfunction decreases for 5 days from 38,5% to 11,5% and persists usually unilateral: left-sided - 7,5%, right-sided - 3,9%.

The only statistically significant surgical factor, influencing high risk of appearance and extantion of post-operative domes dysfunction is unilateral separation of ITA. 

References

1.    Bazylev V.V., Paramonova T.I., Vdovkin A.V. Ocenka faktorov, vlijajushhih na razvitie dispnoje v rannem posleoperacionnom periode posle kardiohirurgicheskih vmeshatel'stv. [Factors affecting the development of dyspnea in the early postoperative period after cardiac surgery.] Diagnosticheskaja i intervencionnaja radiologija. 2016;10(4):19-27 [In Russ].

2.    Davison A., Mulvey D. Idiopathic diaphragmatic weakness. BMJ 1992; 304:492-494.

3.    McCool F.D., McCool G.E. Dysfunction of the Diaphragm. N Engl J Med. 2012; 366:932-942.

4.    Canbaz S., Turgut N., Halici U., et al. Electrophysiological evaluation of phrenic nerve injury during cardiac surgery - a prospective, controlled, clinical study. BMC Surgery. 2004, 4:1-5.

5.    Diehl J.L., Lofaso F., Deleuze P., et al. Clinically relevant diaphragmatic dysfunction after cardiac operations. J Thorac Cardiovasc Surg. 1994; 107:487-498.

6.    McCool F.D., Mead J. Dyspnea on immersion: mechanisms in patients with bilateral diaphragm paralysis. Am Rev Respir Dis. 1989; 139:275-276.

7.    Steier J., Jolley C.J., Seymour J., et al. Sleep-disordered breathing in unilateral diaphragm paralysis or severe weakness. Eur Respir J. 2008; 32:1479-1487.

8.    Kim W.Y, Suh H.J., Hong S.B., et al. Diaphragm dysfunction assessed by ultrasonography: Influence on weaning from mechanical ventilation. Critical Care Medicine. 2011;12:2627-2630.

9.    Deng Y, Byth K., Paterson H.S. Phrenic nerve injury associated with high free right internal mammary artery harvesting. Ann Thorac Surg. 2003; 76(2):459-463.

10.  Mazzoni M., Solinas C., Sisillo E., et al. Intraoperative phrenic nerve monitoring in cardiac surgery. Chest. 1996; 109(6):1455-1460.

11.  Tripp H.F., Sees D.W., Lisagor P.G., et al. Is phrenic nerve dysfunction after cardiac surgery related to internal mammary harvesting? J Card Surg. 2001; 16(3): 228-231.

12.  Metzner A., Rausch P., Lemes C., et al. The incidence of phrenic nerve injury during pulmonary vein isolation using the second-generation 28 mm cryoballoon. J Cardiovasc Electrophysiol. 2014; 25(5):466-470.

13.  Merino-Ramirez M.A., Juan G., Rair^n M., et al. Electrophysiologic evaluation of phrenic nerve and diaphragm function after coronary bypass surgery: prospective study of diabetes and other risk factors. J Thorac Cardiovasc Surg. 2006; 132:530-536.

14.  Paramonova T.I., Vdovkin A.V. Faktory, vlijajushhie na razvitie diafragmal'noj disfunkcii v rannem posleoperacionnom periode posle kardiohirurgicheskih vmeshatel'stv [Factors, influencing the development of diaphragmatic dysfunction in the early postoperative period after cardiac surgery.] Diagnosticheskaja i intervencionnaja radiologija. 2016; 10(2): 11-16 [In Russ].

15.  Chetta A., Rehman A.K., Moxham J., et al. Chest radiography cannot predict diaphragm function. Respir. Med. 2005; 99:39-44.

16.  O'Brien J.W., Johnson S.H., VanSteyn S.J., et al. Effects of internal mammary artery dissection on phrenic nerve perfusion and function. Ann Thorac Surg. 1991; 52: 182-8

17.  Sharma A.D., Parmley C.L., Sreeram G., et al. Peripheral nerve injuries during cardiac surgery: risk factors, diagnosis, prognosis, and prevention. Anesth Analg. 2000; 91(6):13

Abstract:

Aim: was to evaluate the safety and efficacy of coronary stents «MedEng» and to compare them with results of the use of other coronary stents.

Materials and methods: the study included 147 patients with coronary artery disease, which in the period from January to March 2014 underwent coronary stenting. Stents «MedEng» were implanted in 61 patients (group 1). The second group (control) consisted of 86 patients who underwent implantation of stents «Driver». Average follow-up was 6,2±0,5 months. Endpoints were: the return or retention of not less than 2 angina functional class (on CCS); death by cardiac causes, myocardial infarction (MI), repeated intervention on the target vessel, restenosis> 50%, confirmed by angiography and/or the data of optical coherence tomography (OCT)

Results: success rate of stenting was 100%. Death and MI during follow-up were not observed. Restenosis was observed in 9(14,7%) patients in group «MedEng» and in 13 (15,1%) patients from «Driver» group (p = 0,9). The average degree of coronary restenosis was 76,1±8,4% and 76,2±6,4% in the first and second groups, respectively (p=0.9). According to results of logistic regression, stents «MedEng» was not a predictor of restenosis (OR=1,998; 95% CI (0,158-312,551); p = 0,314).

Conclusions: the use of stents «MedEng» is safe and effective in myocardial revascularization. Results of implantation of stents «MedEng» do not different from results of the use of stents «Driver».  

References 

1.    Hoffmann R., Mintz G. Coronary in-stent restenosis - predictors, treatment and prevention. European Heart Journal 2000; 21: 1739-1749.

2.    Ben-Dor I., Waksman R., Pichard A.et al. The Current Role of Bare-Metal Stents. Cardiac interv. 2011; 1: 57-62.

3.    Kastrati A., Sch^mig A., Elezi S., Dirschinger J et al. Prognostic Value of the Modified American College of Cardiology/American Heart Association Stenosis Morphology Classification for Long-Term Angiographic and Clinical Outcome After Coronary Stent Placement. Circulation. 1999; 100: 1285-1290.

4.    Lagerqvist B., James S., Stenestrand U., Lindbck J., Nilsson T., Wallentin L. Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N. Engl. J. Med. 2007; 356: 1009-1019

5.    Sketch M., Ball M., Rutherford B., Popma J.J., Russell C., Kereiakes D.J. Driver Investigators. Evaluation of the Medtronic (Driver) cobalt-chromium alloy coronary stent system. Am. J. Cardiol. 2005;95:8-12.

6.    Farb A., et al., Pathology of acute and chronic coronary stenting in humans. Circulation. 1999; 99(1): p. 44-52.

7.    Sarno G., et al. Lower risk of stent thrombosis and restenosis with unrestricted use of newgeneration drug-eluting stents: a report from the nation wide Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Eur. Heart J. 2012; 33(5): p. 606-13.

8.    Camenzind E., Steg P., Wijns W. Stent thrombosis late after implantation of First-generation drug-eluting stents: a cause for concern. Circulation. 2007; 115: 1440-155.

9.    Lagerqvist B., James S., Stenestrand U., Lindbck J., Nilsson T., Wallentin L. Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N.Engl. J. Med. 2007; 356: 1009-1019.

10.  Bavry A., Kumbhani D., Helton T., et al. Late thrombosis of drug-eluting stents: a metaanalysis of randomized clinical trials. Am. J. Med. 2006;119:1056-1061.

11.  Morice M., Urban P., Greene S., Schuler G., Chevalier B. Why are we still using Coronary Bare-Metal Stents? JACC. 2013;61;1122-3.

12.  Steinberg D., Mishra S., Javaid A., et al. Comparison of effectiveness of bare metal stents versus drug-eluting stents in large (>3.5 mm) coronary arteries. Am. J. Cardiol. 2007;99:599-602.

13.  Kim T., Nam C., Hur S., et al. Two-year clinical outcomes after large coronary stent (4.0 mm) placement: comparison of bare-metal stent versus drug-eluting stent. Clin. Cardiol. 2010;33:620-625.

14.  Bocksch W., Pomar F., Dziarmaga M., Tresukosol D et al. Clinical safety and efficacy of a novel thin-strut cobalt-chromium coronary stent system: results of the real world Coroflex Blue Registry. Catheter Cardiovasc. Interv. 2010 Jan 1;75(1):78-85.

15.  Cassese S., Byrne R., Tada T. et al. Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography. Heart.2014 Jan;100(2):153-9.

16.  Serruys P., Morice M., Kappetein A., et al. SYNTAX Investigators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N. Engl. J. Med. 2009;360:961-972.

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. 

References

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3.     Churton T., Multiple aneurysms of pulmonary artery. BMJ. 1897; 1: 1223.

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5.     Porstmann W. Therapeutic embolization of arteriovenous pulmonary fistula by catheter technique. Current concepts in pediatric radiology. Springer. 1977; 23-31.

6.     Pollak J.S., Saluja S., Thabet A. et al. Clinical and Anatomic Outcomes after Embolotherapy of Pulmonary Arteriovenous Malformations. J. Vasc. Interv. Radiol. 2006; 17: 35-45.

7.     Cirstoveanu C., Balomir A., Bizubac M., Costinean S. Pulmonary arteriovenous malformation - a rare cause of hypoxemia. Practic. Med. 2012; 7: 28.

8.     Koppen S., Korver C., Dalinghaus M., Westermann C. Neonatal pulmonary arteriovenous malformation in hereditary haemorrhagic telangiectasia. Arch. Dis. Child. Fetal Neonatal Ed. 2002; 87: 226-227.

9.     Guidone P., Burrows P., Blickman J. Pediatric case of the day. Congenital pulmonary arteriovenous malformation. Am. J. Roentgenol. 1999; 173: 818-819.

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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:

Revascularization strategy definition in acute coronary syndrome in patients with multivessel coronary artery disease is a significant problem of modern interventional 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.

References

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2.     Cohen D, Stolker J, Wang К, et al. Health-Related Quality of Life After Carotid Stenting Versus Carotid Endarterectomy. Results From CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial). JACC Vol. 2011;15:58.

3.     Amirdjanova V.N., Goryachev D.V., Korshunov N.I., Rebrov A.P., Sorotskaya V.N. Populyatsionnie pokazateli kachestva zhizni po oprosniku SF-36 (rezultati mnogotsentrovogo issledovaniya kachestva zhizni) Mirazh. [Population' indicators of quality of life questionnaire SF-36 (results of a multicenter study of quality of life «MIRAGE»).]. Rheumatology Science and Practice. 2008;46(1):36-48. [In Russ].

4.     Stolker JM, Mahoney EM, Safley DM, et al. Health-related quality of life following carotid stenting versus endarterectomy: results from the SAPPHIRE (Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy) trial. J Am Coll Cardiol Intv. 2010;3: 515-23.

5.     PQcTte E, Slisers M, Miglane E et al. Health-Related Quality of Life Among Patients with Severe Carotid Artery Stenosis. The Journal of Latvian Academy of Sciences. 2015; 5:237-242.

6.     Kazmierski P, Kasielska A, Bogusiak K, Lysakowski M, Stela О gowski M. Influence of internal carotid endarterectomy on patients’ life quality. Pol Przegl Chir. 2012;84:17-22.

7.     Shan L. Saxena A .Quality of Life and Functional Status After Carotid Revascularisation: A Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg. 2015;49: 634-645.

8.     Stolker JM, Mahoney EM, Safley DM, et al. Health-related quality of life following carotid stenting versus endarterectomy: results from the SAPPHIRE (Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy) trial. J Am Coll Cardiol Intv. 2010;3: 515-523.

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Abstract:

Aim: was to determine what dimensions of an end-diastolic volume (EDV) in patients with reducec left ventricular function (LV) higher chances to measure its value up to 50 ml with Echocardiography compared to MRI.

Materials and methods: the sample consisted of 134 patients with ischemic cardiomyopathy and ejection fraction (EF) less than 35%. A mathematical model that calculates what dimensions of the MLC are more likely to determine its size with an accuracy of up to 50 ml with Echocardiography compared to MRI. Produced logistic regression analysis and calculated odds ratios.

Results: аccording to Echocardiography the EDV was 250.5 ± 67.6 ml, EF was 29.4 ± 5.0 percent. According to MRI, the EDV was 249.3 ± 77.2 ml, EF was 29.9 ± 6.4 percent. Results of the logistic regression analysis showed that EDV to 150 ml have high chances of a consistent measure of EDV with Echocardiography and MRI (OR a 2,5). In groups with EDV more than 150 ml but less than 300 ml had low chances of an accurate measurement of the EDV at the Echocardiography (OR from 0,62 to 0,95). Since EDV is greater than 300 ml, a marked increase chances Echocardiography, to determine EDV up to 50 ml compared to MRI (OR from 2,3 to 4,2).

Conclusions: when EDV to 150 ml, and in dilatation of the left ventricle more than 300 ml MRI has no advantages compared to Echocardiography In these figures there is no need to duplicate echocardiographic study When the EDV of 150 to 300 ml, for determination of volumetric indices it is better to use MRI, because the computations do not depend on the geometric shape of the left ventricle.

References

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4.     Malm S., Frigstad S., Sagberg E.; et al. Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography a comparison with magnetic resonance imaging. J Am Coll Cardiol. 2004; 44 (5): 1030-1035.

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