[Hybrid approach to surgical treatment for a saccular thoracic aortic aneurysm]. / Gibridnyi podkhod pri khirurgicheskom lechenii meshotchatoi anevrizmy grudnoi aorty.

Presented herein is a clinical case report regarding hybrid surgical treatment for a saccular aneurysm of the aortic arch in a female patient. While undergoing a routine medical check-up she had been found to have fluorographic evidence strongly suggesting dilatation of the aortic thoracic portion. Based on the findings of further examination we determined the indications for surgical treatment of the thoracic portion of the aorta. The woman was subjected to reconstruction of the arch and the descending portion of the thoracic aorta according to the frozen elephant trunk technique.

[Extra-anatomical bypass grafting of the thoracic aorta in a female patient with an infected pseudoaneurysm]. / Ékstraanatomicheskoe shuntirovanie grudnoi aorty u bol'noi s infitsirovannoi lozhnoi anevrizmoi.

Presented herein is the remote (more than 15-year follow up) result of successful surgical treatment of aortic coarctation complicated by septic aortitis and a false aneurysm of the anastomosis between the graft and the aortic arch. In 2002, after correction of aortic coarctation the woman was admitted to our Clinic with an incompetent proximal anastomosis and an infected aortic pseudoaneurysm. Taking into consideration the general and local septic process, repeat reconstruction of the thoracic aorta was impossible due to the risk for generalization of the infectious process and fatal complications. Therefore, the woman was subjected to extra-anatomical bypass grafting of the thoracic aorta with a synthetic graft from the ascending aorta to the infrarenal portion of the abdominal aorta in order to isolate the infection focus to be followed by removal thereof. The postoperative period turned out uneventful, with no complications. After 15 years, the woman was examined again, with her condition being stable. The findings of contrast-enhanced magnetic resonance imaging demonstrated complete patency of the extra-anatomical bypass graft. The carotid-subclavian anastomosis functioned well, without narrowed portions. No infectious complications after the carried out operations were observed. Using extra-anatomical bypass grafting with exclusion from circulation and removal of the infected portion of the aorta along with the graft is one of reliable variants of treatment for such a severe complication as an infected false aneurysm.

[Microsurgery of coronary arteries using an operating microscope]. / Mikrokhirurgiia koronarnykh arterii s ispol'zovaniem operatsionnogo mikroskopa.

The world experience of coronary artery bypass surgery using an operating microscope is reviewed in the article. Important role of operating microscope and microsurgical techniques for coronary anastomoses formation is shown. High optical magnification provided by operating microscope directly affects the quality of surgical technique and accuracy of coronary anastomoses suturing that affects postoperative graft patency. Thus, the use of operating microscope can affect the results of coronary artery bypass surgery, as shown in several reports.