[Long-term result of aortic root remodeling using the Florida sleeve technique in a patient with connective tissue dysplasia and aortic root aneurysm without aortic insufficiency]. / Otdalennyi rezul'tat ekzoprotezirovaniya kornya aorty po metodike Florida Sleeve u bol'nogo s soedinitel'notkannoi displaziei i anevrizmoi kornya aorty bez aortal'noi nedostatochnosti.

Aortic root remodeling using the Florida sleeve technique was proposed as a simpler alternative to classical reconstructive interventions in patients with aortic root aneurysm without aortic insufficiency. We present a 10-year result of valve-sparing surgical treatment using the Florida sleeve technique in a patient with connective tissue dysplasia and aortic root aneurysm.

[Clinical, biochemical and histological indicators of Del Nido cardioplegia efficacy in patients with severe myocardial hypertrophy]. / Klinicheskie, biokhimicheskie i gistologicheskie pokazateli effektivnosti kardioplegicheskogo rastvora Del Nido u patsientov s vyrazhennoi gipertrofiei miokarda.

OBJECTIVE: To evaluate the effectiveness of two cardioplegia techniques in patients with severe myocardial hypertrophy undergoing septal myectomy or aortic valve replacement. MATERIAL AND METHODS: A comparative pilot prospective single-center randomized study included 46 patients between 2022 and 2023. Patients were randomized into 2 groups: Del Nido (n=23) and Custodiol (n=23). We analyzed perioperative echocardiography data, troponin I at several time points, perioperative complications and histological data. RESULTS: Both groups were comparable in time of myocardial ischemia, cardiopulmonary bypass, duration of anesthesia and surgery (p>0.05). The maximum ischemia time in the Del Nido group was 84 min. The same group showed significantly higher percentage of spontaneous rhythm recovery (65.2% vs. 30%, p=0.008). None patient required mechanical support, high-dose inotropes or vasopressors. Troponin I in 2 hours after cardiopulmonary bypass (p=0.415), 12 (p=0.528) and 24 hours after admission to the intensive care unit (p=0.281) were similar in both groups. No significant difference was found in ventilation time, ICU- and hospital-stay. CONCLUSION: Del Nido cardioplegia has some advantages compared to Custodiol and does not lead to perioperative complications in case of aortic cross-clamping time <90 min in patients with myocardial hypertrophy.

[Mitral valve replacement in patients with obstructive hypertrophic cardiomyopathy]. / Protezirovanie mitral'nogo klapana u bol'nykh obstruktivnoi gipertroficheskoi kardiomiopatiei.

OBJECTIVE: To analyze the incidence and causes of mitral valve replacement in patients with obstructive hypertrophic cardiomyopathy (HCM). MATERIAL AND METHODS: There were 172 patients (98 women and 74 men) with obstructive HCM and severe mitral valve insufficiency between November 2017 and May 2023. All patients complained of chronic heart failure NYHA class III. Surgical correction of left ventricular outflow tract (LVOT) obstruction and mitral valve repair with elimination of systolic anterior motion were technically successful in 160 (93.0%) patients. RESULTS: The need for mitral valve replacement was noted in 12 (7.0%) patients. Mean cardiopulmonary bypass time was 83.5±19.2 min (94; 127), aortic cross-clamping - 62.8±14.3 min (70; 102). In 5 cases, primary mitral valve replacement was scheduled due to obvious organic lesion of the mitral valve (tearing of chords, rheumatic lesion with leaflet restriction). In 7 patients, valve replacement was forced after ineffective primary septal myectomy (LVOT pressure gradient, severe mitral insufficiency). CONCLUSION: Mitral valve replacement is an involuntary strategy after ineffective myectomy with severe mitral insufficiency and high LVOT pressure gradient.

[Combination of chronic obstructive pulmonary disease and arterial hypertension in the elderly: clinical and hemodynamic features and quality of life.]

Clinical features, hemodynamics and quality of life of elderly patients with a combination of chronic obstructive pulmonary disease and arterial hypertension were assessed. The results of the study suggest that in the case of a combination of arterial hypertension and chronic lung disease, not only distinct clinical, functional and hemodynamic changes are observed, but also a significant decrease in the quality of life, largely determined by the severity of the symptoms of both diseases, as well as the severity of the comorbid pathology. The revealed changes in elderly patients with chronic obstructive pulmonary disease and arterial hypertension dictate the need to optimize, first of all, the outpatient stage of observation and rehabilitation of elderly patients with comorbid pathology.

[In-hospital and mid-term results of aortic root remodeling and aortic valve annuloplasty in patients with aortic root aneurysm and no severe aortic valve disease]. / Gospital'nye i sredneotdalennye rezul'taty remodelirovaniya kornya aorty s annuloplastikoi aortal'nogo klapana u bol'nykh s anevrizmoi kornya aorty bez vyrazhennogo organicheskogo porazheniya aortal'nogo klapana.

OBJECTIVE: To analyze early and mid-term results of aortic root remodeling with aortic valve annuloplasty in patients with aortic root aneurysm and no severe aortic valve disease. MATERIAL AND METHODS: There were 33 patients with connective tissue dysplasia, aneurysm of aortic root and/or ascending aorta and aortic regurgitation between September 2019 and December 2022. All patients underwent aortic root remodeling with aortic valve annuloplasty. RESULTS: Mean time of cardiopulmonary bypass was 138.5±21.5 min, aortic clamping - 115.3±20.5 min. According to postoperative transthoracic echocardiography, mild aortic regurgitation was observed in 28 patients, 5 patients had moderate regurgitation. Postoperative follow-up period varied from 3 months to 2 years. There was no in-hospital mortality or significant cardiovascular complications. Two-year freedom from moderate-to-severe aortic regurgitation was 93.9%, overall survival - 100%. CONCLUSION: Aortic root remodeling is characterized by favorable hemodynamic efficiency and low complication rate.

[The use of augmented reality technology in endoscopic removal of a maxillary cyst]. / Primenenie tekhnologii dopolnennoi real'nosti v kachestve navigatsionnoi sistemy pri endovideoassotsiirovannom udalenii kisty verkhnei chelyusti.

This article describes the use of augmented reality technology for the removal of an odontogenic cyst of the upper jaw. By combining the image of computed tomography, anatomical formations and the tip of the endoscope in mixed reality, a navigation system was created for performing cystectomy and resection of the tip of the molar root for a volumetric cyst of the maxillary sinus. For the first time, a system for tracking the position of an endoscope in mixed reality in real time was used.

[The risk factors studying for chronic obstructive pulmonary disease development in non-smoking elderly patients.]

In 524 elderly patients with COPD, risk factors for the development of the underlying disease were assessed. It turned out that a significant proportion of elderly patients with COPD had never been exposed to tobacco smoke. A previous diagnosis of asthma in elderly patients is associated with an increased risk of developing COPD among never-smokers. Exposure to organic dust in the workplace and a history of severe childhood respiratory tract infections also increase the risk of an underlying disease. The data obtained determine the need for an integrated approach to the analysis of risk factors for the development of COPD in non-smoking patients in order to draw up individual preventive programs aimed at preventing the development and progression of the disease.

[The combined use of peptide bioregulators and self-massage in order to improve the psychophysiological state and increase the professional performance of the elderly.]

The development of modern society is characterized by an increase in the volume and changing forms of information presentation. In the works of Russian and foreign gerontologists, it is noted that the perception and analysis of the flow of relevant data today causes difficulties for a significant part of citizens of older age groups, which is due, among other things, to the deterioration of their psychophysiological state. The lack of the ability to use the necessary information negatively affects the quality of life, the level of social adaptation and professional competence. This problem is particularly significant for population groups and professional communities, whose life and activities require the actualization of certain sectors of the information field. Typical examples of such groups are citizens of retirement age who continue professional activities related to the mobilization of intellectual and creative potential, in particular, university teachers. The use of gerontotechnologies contributes to solving the problem, which provides for the development of effective methods for correcting the functional state of elderly citizens, in particular, increasing the ability to perceive information and the level of vital activity. This publication presents the results of an experimental study of the effectiveness of the combined use of peptide bioregulators and massage on the level of professional performance of elderly teachers of a pedagogical university.

[Accelerated aging as a risk of the education digitalization: possibilities for prevention.]

The work is devoted to the analysis of the education digitalization negative effects and the possibilities of their prevention consideration. The urgency of this problem in the modern conditions of combating the pandemic of the new coronavirus infection and moving a significant part of education and leisure to the virtual space is noted. Against the background of a deficit in physical activity and an increase in the information consumption duration, the participants in the experiment showed a significant increase in the frequency of mental and physical maladjustment symptoms occurrence, a decrease in performance indicators and a deterioration in the biological age parameters. The geroprotective effect of correcting the student lifestyle with an emphasis on information hygiene, optimizing sleep, rest, motor and nutritional regimen in terms of qualitative and quantitative indicators is shown.

[Aortic root remodeling and aortic valve annuloplasty in patients with aortic root aneurysm and no severe aortic valve disease]. / Remodelirovanie kornya aorty s annuloplastikoi aortal'nogo klapana u bol'nykh s anevrizmoi kornya aorty bez vyrazhennogo organicheskogo porazheniya aortal'nogo klapana.

OBJECTIVE: Analysis of the outcomes after aortic root remodeling with aortic valve annuloplasty in patients with aortic root aneurysm and no severe aortic valve disease. MATERIAL AND METHODS: There were 19 patients with connective tissue dysplasia, aneurysm of aortic root and/or ascending aorta and aortic regurgitation between September 2020 and December 2021. All patients underwent aortic root remodeling with aortic valve annuloplasty. RESULTS: Mean time of cardiopulmonary bypass was 148.7±23.5 min, aortic clamping - 117.3±19.5 min. According to postoperative transthoracic echocardiography, mild aortic regurgitation was observed in 6 patients, 13 patients had no regurgitation. There was no in-hospital mortality or significant cardiovascular complications. Freedom from moderate-to-severe aortic regurgitation after 14 months was 94.7%, overall survival - 100%. CONCLUSION: Aortic root remodeling is characterized by favorable hemodynamic efficiency and low complication rate. Further accumulation of data with clinical analysis are planned for a more accurate assessment of effectiveness of surgical treatment, determination of predictors of successful reconstruction, development of indications, contraindications and a personalized algorithm for patient selection.

[Mystery of endometriosis - catamenial pneumothorax]. / Zagadki endometrioza ­ katamenial'nyi pnevmotoraks.

The review is devoted to clinical picture, main theories of pathogenesis, traditional and innovative methods of diagnosis and surgical treatment of catamenial pneumothorax. Currently, clinicians prefer magnetic resonance imaging and thoracoscopy for diagnosis of this disease. Various researchers are actively searching for laboratory diagnostic methods that can confirm endometrioid nature of pneumothorax. Treatment and prevention of catamenial pneumothorax are a controversial issue depending both clinical picture and preferences of the attending physician. Currently, the majority of authors believe that hormonal therapy combined with diaphragm resection ensures optimal anti-relapse effect in patients with thoracic endometriosis.

[Surgical treatment of obstructive hypertrophic cardiomyopathy combined with muscle bridging of the left anterior descending artery]. / Khirurgicheskoe lechenie obstruktivnoi gipertroficheskoi kardiomiopatii v sochetanii s miokardial'nym mostikom perednei niskhodyashchei arterii.

Myocardial bridging is often detected during diagnostic coronary angiography in patients with congenital and acquired heart defects. In most cases, muscle bridging does not require surgical treatment. Myocardial bridging and tunnels causing compression of one or more major coronary arteries is a potential cause of myocardial ischemia in patients with hypertrophic cardiomyopathy. The authors report surgical treatment of a patient with obstructive hypertrophic cardiomyopathy and myocardial bridging of the left anterior descending artery.

[Surgical approaches to interventricular septum in hypertrophic cardiomyopathy]. / Varianty dostupa k mezhzheludochkovoi peregorodke serdtsa pri gipertroficheskoi kardiomiopatii.

Hypertrophic cardiomyopathy (HCM) is a hereditary myocardial disease characterized by ventricular wall and interventricular septum thickening not associated with heart valve disease or any other external cause. Considering different localization of left ventricular obstruction, surgeons should be aware of various surgical approaches to various segments of interventricular septum. A personalized approach to each patient is essential to achieve favorable postoperative effect with minimal incidence of complications. This review is devoted to various surgical approaches to interventricular septum for different phenotypic variants of HCM.

[Hemostatic measures in reconstructive aortic root surgery]. / Metody kontrolya krovotecheniya v rekonstruktivnoi khirurgii kornya aorty.

Bleeding is a significant cause of complications and mortality in surgery for ascending aorta and aortic root disease. This is especially true after complex reconstructions associated with hypothermic circulatory arrest and long-standing cardiopulmonary bypass. The review is devoted to modern methods of hemostasis in reconstructive aortic root surgery.

[Redo tricuspid valve replacement with mechanical prosthesis for repeated early bioprosthetic valve failure]. / Reprotezirovanie trikuspidal'nogo klapana mekhanicheskim protezom u patsientki s povtornoi rannei disfunktsiei bioproteza.

Tricuspid leaflet lesion following infective endocarditis is a severe condition requiring surgical treatment in most cases. Currently, tricuspid valve replacement with mechanical prosthesis is still essential in the treatment of patients ineligible for reconstructive surgery or bioprosthesis implantation. The authors describe redo tricuspid valve replacement with mechanical prosthesis for repeated early bioprosthetic valve failure.

[Results of endocardial pulmonary vein cryoablation in patients with atrial fibrillation undergoing on-pump cardiac surgery]. / Rezul'taty krioablyatsii ust'ev legochnykh ven u patsientov s fibrillyatsiei predserdii pri kardiokhirurgicheskikh operatsiyakh v usloviyakh iskusstvennogo krovoobrashcheniya.

OBJECTIVE: To analyze the results of endocardial pulmonary vein cryoablation in patients with atrial fibrillation (AF) undergoing on-pump cardiac surgery. MATERIAL AND METHODS: The authors report postoperative outcomes in 19 patients after on-pump coronary artery bypass grafting and/or heart valve surgery and endocardial pulmonary vein cryoablation for concomitant AF. All procedures were performed for the period from September 2018 to December 2020. RESULTS: Successful procedure was determined by restoration of stable sinus rhythm in postoperative period. In 14 (79%) patients, sinus rhythm was restored in early postoperative period. In 5 (21%) patients (2 women, 3 men), AF recurred within 6-12 days after surgery. In one patient, postoperative period was complicated by atrioventricular blockade grade I. CONCLUSION: Endocardial pulmonary vein cryoablation is effective for AF. This procedure is expedient in patients with concomitant cardiac disease scheduled for open heart surgery.

[Clinical and functional features of chronic obstructive pulmonary disease in elderly patients in the Rostov region.]

The study showed the presence of COPD clinical and functional features in elderly patients. Among the statistically significant features, one should highlight the high incidence of COPD (49,7% of the total number of elderly examined) in combination with the shortest duration of the disease in the group of people who have never smoked; the greatest degree of airflow restriction, the maximum severity of pulmonary hypertension and hypoxemia, along with the highest frequency and severity of exacerbations of the underlying disease in the group of patients with COPD, indicating the presence of occupational hazards in the history; the minimum pronounced decrease in quality of life indicators in the group of smokers in combination with an earlier onset of the underlying disease (in comparison with non-smoking patients of the same age). The revealed features can be informative in the diagnosis, treatment, prognosis of the underlying disease and the development of more effective methods of prevention and rehabilitation.

[Simultaneous surgical correction of post-infarction left ventricular aneurysm and residual ventricular septal defect in long-term period after transcatheter implantation of occluders]. / Sochetannaya khirurgicheskaya korrektsiya postinfarktnoi anevrizmy levogo zheludochka i rekanalizovannogo defekta mezhzheludochkovoi peregorodki v otdalennom periode posle transkateternoi implantatsii okklyuderov.

Post-infarction ventricular septal defect (VSD) is a rare but formidable complication of myocardial infarction following mortality rate up to 90% without invasive treatment. Surgical closure is preferred for VSD. The authors report successful surgical treatment of a patient with post-infarction LV aneurysm and residual post-infarction VSD in 5 years after implantation of two occluders.

[Ascending aorta and aortic arch hypoplasia in a patient with connective tissue dysplasia and multiple deficit of coagulation factors]. / Gipoplaziya voskhodyashchego otdela i dugi aorty u bol'nogo s displaziei soedinitel'noi tkani i kombinirovannym defitsitom plazmennykh faktorov svertyvaniya.

Connective tissue dysplasia (CTD) is an urgent problem, especially in young and employable people. Damage to cardiovascular system and, in particular, aorta is predominant factor determining the incidence of various complications and mortality in patients with CTD. The authors report surgical treatment of aortic hypoplasia in an adolescent patient with connective tissue dysplasia syndrome and combined deficiency of coagulation factors.

[The role of functional and instrumental research methods in the diagnosis and control of chronic obstructive pulmonary disease in the elderly.]

In more than 500 elderly patients with COPD, the frequency of spiral computed tomography (SCT) of the lungs and echo-CG of the heart was evaluated for diagnostic purposes and to monitor the course of the disease. The study showed that despite the high clinical significance of the FEV1 indicator (the volume of forced exhalation in the first second), the indicator itself is extremely non-specific when diagnosing COPD in elderly patients. The high specificity of lung CT makes it necessary to use this diagnostic method in elderly patients to detect morphological changes in the lungs in the presence of clinical signs of bronchial obstruction and negative spirometry data. It is necessary to strengthen the role of echocardiography in the diagnosis of chronic pulmonary heart disease and stratification of the severity of the underlying disease in elderly patients with COPD.