RESUMO
The problem of haemostasis in cardiovascular surgery is of current concern. Recent trends are towards increased use of topical haemostatic agents. Tachocomb has been used for more than 30 years in abdominal surgery and oncology. The purpose of the present publication is to analyse the literature data and formulate the indications for the use of Tachocomb in cardiovascular surgery. Multicenter randomized and local studies have demonstrated efficacy of Tachocomb in treatment of surgical haemorrhage in operations on the heart, thoracic aorta, carotid arteries and lower-limb arteries, resulting in significantly decreased time to achieve haemostasis, decreased volume of blood loss and haemotrasfusion, as well as reduced frequency of complications. Also shown was economic efficacy, including a shortened length of patients' hospital stay. This is followed by describing a wide spectrum of examples of alternative use of Tachocomb, including its use for seamless closure of defects of cardiac chamber walls, aero- and lymphostasis, prevention of formation of commissures. Convincing experimental and clinical results make it possible to formulate a series of indications for the use of Tachocomb in cardiovascular surgery.
Assuntos
Procedimentos Cirúrgicos Cardiovasculares , Hemostáticos , Trombina , Perda Sanguínea Cirúrgica , Hemostasia , Hemostasia Cirúrgica , Hemostáticos/uso terapêutico , HumanosRESUMO
The frequency of use of assist blood device as the "bridge" to the heart transplantation increased in last years. An assessment of results of first 7 implantations of assist circulation device using biventricular type "Excor" was made. The implantations were performed in Federal Almazov centre of the heart, blood and endocrinology. An observation period after implantation was since 11 till 301 days. The heart transplantation of 4 patients was carried out in different terms after implantation. One of the patients passed away on the fifth day due to the pulmonary embolism. Another patient died on the eleventh day after the implantation because of multiple organ failure against the background of severe chronic cardiac failure. The waiting list of heart transplantation includes 2 patients.
Assuntos
Circulação Assistida , Insuficiência Cardíaca , Transplante de Coração/métodos , Coração Auxiliar , Adolescente , Adulto , Circulação Assistida/instrumentação , Circulação Assistida/métodos , Desenho de Equipamento , Feminino , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/cirurgia , Humanos , Imunossupressores/uso terapêutico , Masculino , Período Pós-Operatório , Cuidados Pré-Operatórios/métodos , Índice de Gravidade de Doença , Análise de Sobrevida , Resultado do Tratamento , Listas de EsperaRESUMO
At the present time heart transplantation is considered to be the operation of choice in treatment of patients with terminal stage of chronic heart failure. Results of the first 5 heart transplantations made in the Federal Center of the heart, blood and endocrinology named after V. A. Almazov are assessed. There were no perioperational lethality and complications at the hospital stage. An analysis of the long-term results has shown effectiveness of heart transplantations in treatment of severe heart pathology.
Assuntos
Rejeição de Enxerto , Insuficiência Cardíaca/cirurgia , Transplante de Coração/métodos , Monitorização Fisiológica/métodos , Assistência Perioperatória/métodos , Coleta de Tecidos e Órgãos/métodos , Adulto , Biópsia , Doença Crônica , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Insuficiência Cardíaca/patologia , Insuficiência Cardíaca/fisiopatologia , Transplante de Coração/imunologia , Transplante de Coração/mortalidade , Transplante de Coração/patologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/normas , Assistência Perioperatória/normas , Complicações Pós-Operatórias/imunologia , Complicações Pós-Operatórias/prevenção & controle , Índice de Gravidade de Doença , Coleta de Tecidos e Órgãos/normas , Resultado do TratamentoRESUMO
The authors discuss results of more than 300 operations of the aorto-coronary bypass using the radial artery as a shunt. An analysis of the initial state of the patients, the intraoperative, early postoperative and intrahospital periods was made. Special attention was given to specific features of the isolating and using the radial artery grafts. Specific complications resulting from the application of them were analyzed and recommendations are given for prophylactics of such complications. The experiences with using the radial arteries allow to recommend it in revascularization of the myocardium. It is one of the ways of improving immediate and long-term results of operations on patients with ischemic heart disease.
Assuntos
Ponte de Artéria Coronária/métodos , Artéria Radial/transplante , Adulto , Idoso , Ponte de Artéria Coronária/mortalidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Isquemia Miocárdica/cirurgia , Complicações Pós-Operatórias , Fatores de TempoRESUMO
The authors describe a technique of the isolation, preparation and use of the radial artery for the aortocoronary shunting for ischemic heart disease. The method is anatomically valid and approbated in 300 operations on the open heart. Safety and efficiency of using the radial artery is due to its not traumatic isolation, original preparing for shunting and medicamental prevention of its spasm.
