[Right ventricle free wall rupture during transcatheter occluder implantation in a patient with postinfarction rupture of the interventricular septum and COVID-19-associated myocarditis. Case report].

Intraventricular septum rupture is a rare mechanic complication of myocardial infarction associated with high mortality. This case describes STEMI in recovered patient after COVID 19 associated pneumonia, which was complicated by ventricular septum rupture followed by cardiogenic shock. It was managed by percutaneous occluder implantation. The procedure was complicated by right ventricular wall rupture. Postmortem examination of myocardium showed the signs of inflammation infiltrate and myocyte necrosis, according to histopathological Dallas criteria diagnosis of COVID-19 associated myocarditis was established. The COVID-19 pandemic has contributed to increasing cardiovascular mortality. This is typically attributed to diminishing resources for timely and appropriate medical care, and patients' late presentations for fear of contracting the infection. Cardiovascular complication of COVID-19 may be another contributing factor. Further research is needed to improve our understanding of the mechanisms and long-term sequelae of myocardium damage in COVID-19, to optimize treatment strategy and subsequent follow-up in such patients.

[Endovascular closure of a ventricular septal defect from Takotsubo Syndrome].

Takotsubo Syndrome is a transient condition characterized by left ventricular systolic dysfunction. Although the prognosis is excellent in most cases, rare cases of serious complications can occur. We present a case of a 81-year - old woman with Takotsubo Syndrome complicated by ventricular septal rupture that was successfully closed with an occluder Occlutech with good immediate and long - term outcomes.

[Endovascular treatment of major vascular aneurysms: successful experience].

Major vascular aneurysm is a severe pathology with poor prognosis. Due to wide variations of vascular anatomy, an endovascular intervention may require intraoperative adjustment of procedural strategy. The paper presents results of successive stent-graft implantations in different anatomical situations.

[A case of surgical treatment of post-traumatic false arteriovenous aneurysm of the right kidney vessels]. / Sluchai khirurgicheskogo lecheniia posttravmaticheskoi lozhnoi arteriovenoznoi anevrizmy sosudov pravoi pochki.

This paper describes an experience gained with successful surgical correction of post-traumatic false aneurysm of the right kidney vessels in a 36-year-old patient operated on previously for knife wound and intrahepatic abscess. All-round examination (duplex scanning of the renal arteries, multispiral computed tomography, abdominal aortography, and ultrasonography of the kidneys) revealed a false aneurysm of the medium segment of the right kidney artery measuring 31x21x33 mm. The aneurysm was located downwards, to the rear and inwards from the artery, with marginal posteroinferior calcification drained to the venous collector (the right kidney vein) expanded to 36-40 mm. The preoperative diagnosis: a post- traumatic false arteriovenous aneurysm of the right kidney vessels; vasorenal hypertension; IIa stage circulatory insufficiency; chronic pyelonephritis, remission; hydronephrosis on the right; 0-I stage chronic renal insufficiency. In view of the failure of the attempts to accomplish endovascular intervention, progression of right ventricular heart insufficiency, the presence of vasorenal hypertension, and right kidney malfunction we performed operation which consisted in evacuation of the false arteriovenous aneurysm of the right kidney artery, plasty of the defect of the right kidney vein and of the defect of the right kidney artery by the aneurysmal wall. The postoperative period was uneventful. Control ultrasonography failed to discover arteriovenous shunting at the level of the right kidney arteries. Also, auscultation did not reveal any murmur in the projection of the renal vessels on the right and above the abdominal aorta. On the 14th postoperative day the patient was discharged from the clinic in a satisfactory condition. His laboratory and hemodynamic parameters were good.

[Clinical assessment of immediate results of various methods of myocardial revascularization in ischemic heart disease patients with isolated anterior descending coronary artery disease]. / Klinicheskaia otsenka neposredstvennykh rezul'tatov razlichnykh metodov revaskuliarizatsii miokarda u bol'nykh ishemicheskoi bolezn'iu serdtsa s izolirovannym porazheniem perednei niskhodiashchei arterii.

Open heart coronary artery bypass grafting (CABG), minimally invasive coronary artery surgery, transluminal balloon coronary angioplasty (TBCA) and coronary stenting were carried out in 25, 35, 12 and 38 patients with isolated anterior descending coronary artery disease, respectively. In immediate period after procedures there were 2 deaths (among patients subjected to open heart CABG and TBCA) and 2 nonfatal myocardial infarctions (among patients treated with TBCA and stenting). In 2 patients repeat interventions were performed during initial hospitalization (in 1 after TBCA and in 1 after stenting). Exercise tolerance increased by 40+/-8, 44+/-7, 45+/-8, 53+/-9 W in patients treated with open heart CABG, minimally invasive surgery, TBCA and stenting, respectively. Thus surgical and endovascular methods of treatment of patients with isolated anterior descending coronary artery lesions produced beneficial clinical effect and were associated with relatively low rate of postoperative complications.

[Endovascular treatment of subclavian arterial aneurysm using stent graft]. / Lecheniia anevrizmy podkliuchichnoi arterii s pomoshch'iu stent-grafta.

The authors describe a clinical case of successful endovascular treatment of subclavian arterial pseudoaneurysm using the stent graft JOSTENT-GRAFT 48 mm in length and 6 mm in diameter in a 49-year-old patient. The aneurysm developed over a length of 2 years as a result of polytrauma without remarkable circulatory disorders in the distal arterial bed of the upper extremity. Further existence of aneurysm was conjugated with a risk of ischemic or neurologic complications. This observation demonstrates the current potential of roentgenoendovascular surgery allowing to successfully replace the technically difficult and traumatic surgical intervention in the event of formation of pseudoaneurysms by the pulsatory hematoma type.