Procedure of complex braided wrapping of ascending aorta in her poststenotic dilation while doing correction of aortal stenosis

Objective. To study clinical possibilities of original procedure of the ascending aorta braid-like bandage for her poststenotic dilation while performance of the aortal stenosis surgical correction. Materials and methods. To the main Group 196 patients were included those, who were operated on for prevailing aortal stenosis, conjoined with poststenotic dilation of ascending aorta. In accordance to the echocardiographic investigation data the ascending aorta diameter preoperatively have constituted (47.7 ± 1.7) mm. In all the patients the aortal valve prosthesis was performed together with complex braided wrapping of ascending aorta. Into the control group 121 patients were included, in whom Bentall intervention was accomplished with vascular prosthesis of ascending aorta. Results. Hospital lethality in the main group have constituted 0.5%. Diameter of ascending aorta in the moment of hospital discharge have constituted (39.1 ± 1.5) mm, and in late follow-up period - (40.3 ± 1.1) mm. Conclusion. Basing on clinical experience gained, it is expedient to recommend the original procedure of braided wrapping of ascending aorta in presence of her poststenotic dilation while performing surgical correction of prevailing aortal stenosis.

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Impact of Regular Physical Activity on Aortic Diameter Progression in Paediatric Patients with Bicuspid Aortic Valve

Pediatric Cardiology ◽

10.1007/s00246-021-02591-4 ◽

2021 ◽

Author(s):

Emanuele Monda ◽

◽

Adelaide Fusco ◽

Alessandro Della Corte ◽

Martina Caiazza ◽

...

Keyword(s):

Physical Activity ◽

Ascending Aorta ◽

Regular Physical Activity ◽

Aortic Diameter ◽

Sinus Of Valsalva ◽

Physically Active ◽

The Impact ◽

Aorta Diameter ◽

Sedentary Subjects

AbstractPatients with bicuspid aortic valve (BAV) have an increased risk of aortic dilation and aortic dissection or rupture. The impact of physical training on the natural course of aortopathy in BAV patients remains unclear. The aim of this study was to evaluate the impact of regular physical activity on aortic diameters in a consecutive cohort of paediatric patients with BAV. Consecutive paediatric BAV patients were evaluated and categorized into two groups: physically active and sedentary subjects. Only the subjects with a complete 2-year follow-up were included in the study. To evaluate the potential impact of physical activity on aortic size, aortic diameters were measured at the sinus of Valsalva and mid-ascending aorta using echocardiography. We defined aortic diameter progression the increase of aortic diameter ≥ 10% from baseline. Among 90 BAV patients (11.5 ± 3.4 years of age, 77% males), 53 (59%) were physically active subjects. Compared to sedentary, physically active subjects were not significantly more likely to have > 10% increase in sinus of Valsalva (13% vs. 8%, p-value = 0.45) or mid-ascending aorta diameter (9% vs. 13%, p-value = 0.55) at 2 years follow-up, both in subjects with sinus of Valsalva diameter progression (3.7 ± 1.0 mm vs. 3.5 ± 0.8 mm, p-value = 0.67) and in those with ascending aorta diameter progression (3.0 ± 0.8 mm vs. 3.2 ± 1.3 mm, p-value = 0.83). In our paediatric cohort of BAV patients, the prevalence and the degree of aortic diameter progression was not significantly different between physically active and sedentary subjects, suggesting that aortic dilation is unrelated to regular physical activity over a 2-year period.

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Progressive Scoliosis and Syringomyelia - Questions of Surgical Approach

Folia Medica ◽

10.1515/folmed-2017-0099 ◽

2018 ◽

Vol 60 (2) ◽

pp. 261-269 ◽

Cited By ~ 1

Author(s):

Mikhail Mikhaylovskiy ◽

Vyacheslav Stupak ◽

Vadim Belozerov ◽

Nikolay Fomichev ◽

Anatoliy Lutsik ◽

...

Keyword(s):

Surgical Intervention ◽

Surgical Correction ◽

Neurological Deficits ◽

Spinal Deformities ◽

Loss Of Correction ◽

Scoliotic Deformity ◽

Scoliosis Correction ◽

The Moment ◽

Comparison Of The Results

Abstract Background: The rate of scoliosis in syringomyelia patients ranges from 25 to 74.4%. In turn, syringomyelia occurs in 1.2% to 9.7% of scoliosis patients. Aim: To evaluate outcomes of surgical correction of the scoliotic deformity in syringomyelia patients. Materials and methods: Between 1996 and 2015, 3120 patients with scoliosis of various etiologies were treated at the Clinic for Child and Adolescent Vertebrology of the Novosibirsk Research Institute of Traumatology and Orthopedics. We conducted a retrospective analysis of syringomyelia-associated scoliosis cases that required surgical correction. Results: Syringomyelia was found in 33 patients (1.05%) out of 3120 patients with spinal deformities of various etiologies; in 21 patients (0.9%) with idiopathic scoliosis of 2334 patients. In identifying the neurological deficit, the recommended first step is to perform neurosurgery. Nineteen patients were operated using the CDI, 4 patients underwent correction VEPTR, in 1 case instrumentation could not be established, 9 patients are undergoing treatment in the department of neurosurgery at the moment. Worsening of neurological deficits was not observed in any patient. Conclusion: A comparison of the results of syringomyelia-associated scoliosis correction with the data of other authors was done. The choice of surgery tactics is strictly individual and depends on the size of the cavity. The result of surgical intervention is generally positive and the loss of correction by the end of follow-up is negligible.

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Left Atrial Shape and Function after Endovascular Device and Surgical Closure of ASDs in Children

10.22541/au.162498188.88902606/v1 ◽

2021 ◽

Author(s):

Alexander Sokolov ◽

Viktor Varvarenko ◽

Evgeny Krivoshchekov ◽

Andrey Smorgon

Keyword(s):

Left Atrium ◽

Left Atrial ◽

Surgical Correction ◽

Control Group ◽

Surgical Closure ◽

Younger Age ◽

Asd Closure ◽

And Function ◽

Endovascular Device

Retrospective analysis of echocardiograms was performed in 756 children who received endovascular device or surgical ASD closure from 2006 to 2016 in the Cardiac Center in Tomsk Russia. 564 patients had an endovascular closure and 192 had surgical correction. Follow-up duration was from 1 day to 10 years, mean 3.6 yrs for the device group and 4.2 yrs for the surgery group. The control group consisted of 3393 age-matched healthy patients. In patients with endovascular closure of an ASD, 35% had a change in the shape of the left atrium in early follow-up. Changes in the shape of the left atrium at early follow-up were more often observed in the device group and in children of a younger age. The left atrial changes were a decrease in sphericity and an increase in ellipsoidy. Changes in the shape of the left atrium persisted in 22% after transcatheter correction in the long-term. The change in shape of the left atrium after the placement of ASD devices was accompanied by activation of the mechanical function of the atrium and an increase in the filling pressure of the left ventricle. These changes were not accompanied by any disturbance in the contractility and volume of the heart chambers. In the group with surgical correction of ASD, the contractility and volume of the heart chambers did not significantly differ from those in the device closure group

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Diagnosis of the Syndrome of Excessive Bacterial Growth of the Small Intestine in Patients with Bauhinia Insufficiency and After its Surgical Correction (First Results)

10.47363/jpr/2020(2)116 ◽

2020 ◽

pp. 1-6

Author(s):

Vladimir Leonidovich Martynov ◽

◽

Natalia Vladimirovna Kazarina ◽

Keyword(s):

Small Intestine ◽

Bacterial Growth ◽

Ileocecal Valve ◽

Normal Function ◽

Main Group ◽

Surgical Correction ◽

Control Group ◽

Distal Small Intestine ◽

First Results ◽

Respiratory Test

Objective: To determine the syndrome of excessive bacterial growth in the small intestine (SIBO) in patients with insufficiency of the bauhinia valve (NBZ) and after its surgical correction. Methods of examination: Patients of the studied groups were examined using direct and indirect methods of diagnosis of SIBO. Bacteriological examination of ileal aspirate and other surgical material was performed. All patients underwent a hydrogen respiratory test with a load of lactulose and performed a qualitative reaction of urine to indican. Characteristics of the material: 50 patients were examined, of which 30 were included in the main group, who underwent surgical correction of NBZ - Bauginoplasty; 20 patients are included in the control group in which the ileocecal valve is consistent. Patients of the main group were examined before surgery and on the 7th and 45th day after Bauhinoplasty. Main results: All patients of the main group had SIBS of varying severity, in 80% of patients SIBS was localized in the distal small intestine. Patients with normal function of ileocecal valve syndrome of excessive bacterial growth did not suffer. Intraoperatively, 76% of patients showed signs of mesenteric mesentery of the small intestine, and the fact of bacterial translocation in SIBO was also confirmed. After 7 days after surgical correction of the Bauhinia valve, the normalization of peak and background excretion of hydrogen was observed in 37% of patients. For 45 days in all patients the hydrogen curve corresponded to the norm. Conclusions: the deficiency of the bauhinia valve is obligately accompanied by the syndrome of excessive bacterial growth in the small intestine, surgical correction is an effective method for correcting the syndrome of excessive bacterial growth in patients with NBD.

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P2686Endothelial reaction mediates enhanced external counterpulsation effects in post-MI cardiac rehabilitation

European Heart Journal ◽

10.1093/eurheartj/ehz748.1004 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

D V Shishkin ◽

S L Mikheev ◽

V V Neznanov

Keyword(s):

Endothelial Function ◽

Cardiac Rehabilitation ◽

Exercise Capacity ◽

Exercise Tolerance ◽

Main Group ◽

Control Group ◽

External Counterpulsation ◽

Nitrite Level ◽

Enhanced External Counterpulsation

Abstract Introduction The mechanisms mediating benefits of enhanced external counterpulsation (EECP) are disputable since the origin of the method. One of the possible explanations presumes increased diastolic flow leads to changes of endothelial function and plays a crucial role in alleviating the symptoms of angina and heart failure; the exact mechanisms of action are still under investigation, though the endothelial hypothesis possesses strong evidence. Purpose To reveal the impact of repeated EECP on endothelial function of patients undergoing cardiac rehabilitation program after myocardial infarction (MI) and to identify possible clinical implications of these changes. Methods The randomized sham-controlled study included 46 patients with coronary artery disease who suffered from ST-elevation MI (STEMI) 4–8 weeks prior to enrollment in 2017–2018. All patients had undergone primary PCI due to STEMI in 2–24 hours after the event. Echo parameters, exercise tolerance and the levels of ADMA and nitric oxide (NO) metabolites (total content, nitrite and nitrate) in plasma were determined at the enrollment stage and at three month follow-up. Patients were randomized and given 35 h of active counterpulsation (main group, n=24) or inactive counterpulsation (control group, n=22) over a six-week period after enrollment. Results The analysis showed no significant difference between groups at baseline: mean ejection fraction was 46% in the main group and 45% in the control group, no difference in exercise tolerance. The mean characteristics of endothelial function at baseline were similar in both main and control groups: total NO metabolites (17.3±2.14 μmol/L vs. 19.6±3.31, p=0. 42), nitrite level (0.76±0.17 μmol/L vs. 0.75±0.21, p=0. 36), ADMA level (0.78±0.15 μmol/L vs. 0.81±0.20, p=0. 22). At three month follow up 41,7% of patients of the main group showed improvement of one class of NYHA classification compared to 22,7% in the control group (U=122.3, p=0.012), agreed with improved exercise tolerance: average +2.8 MET in main group in opposite to only +0.8 MET in the controls (U=104, p=0.007). Control group demonstrated no significant dynamics of NO metabolites concentration comparing to baseline values, while in the main group there was a significant decrease of ADMA – 0.57±0.11 μmol/L (Z=r=−2.46, p=0.013) and increase of nitrite level – 1,12±0. 18 μmol/L (Z=r=−2.57, p=0.011), with no changes in total NO metabolites content. The further analysis demonstrated strong correlation between exercise capacity gain and ADMA decrease (R=r=−0.52, p=0.008) or nitrite elevation (R=0.48, p=0.012), with ADMA/nitrite ratio being the strongest predictor of clinical improvement (R=0.68, p=0.002). Conclusion Active EECP improves exercise capacity and heart failre symptoms in patients undergoing post-MI rehabilitation, with those effects being associated with endothelial function enhancement.

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PERIOPERATIVE ANESTHESIA: TO DO OR NOT TO DO?

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.32414/0869-8678-2018-2-36-40 ◽

2018 ◽

Vol 25 (2) ◽

pp. 36-40

Author(s):

S. A. Firsov ◽

A. S. Lepilov ◽

R. P. Matveev ◽

V. S. Savinkin

Keyword(s):

Hip Arthroplasty ◽

Motor System ◽

Main Group ◽

Narcotic Analgesic ◽

Control Group ◽

Control Groups ◽

Treatment Results ◽

Analog Scale ◽

And Control

Introduction. In patients with chronic loco-motor system diseases the pain often persists after arthroplasty and does not respond to symptomatic therapy.Purpose of study: to evaluate the efficacy of perioperative use of Meloxicam in patients after hip arthroplasty. Patients and methods. The follow-up covered 120 patients (mean age 64.4±5.23 years) after hip arthroplasty. In the main group (n=60) Meloxicam was given 7 days prior to and 3 weeks after surgery; after intervention narcotic analgesic was used on the request. In control group (n=60) the patients were only on narcotic analgesic on request after operation. Treatment results were assessed by 100-millimeter visual analog scale (VAS) and D’Aubigné-Postel Score.Results. Seven days before the surgery the pain severity in the main and control groups was comparable: 85±2.3 and 84±2.1, respectively. In 2 days after operation the pain relief was more pronounced in the main group — 69±2.1 mm versus 82±3.4 mm in the control group (p0.05). In 3 months those indices made up 10±2.1 and 35±12.6 mm (p0.001), respectively. In the main group the result was assessed as the excellent and good in 22 patients, in the rest of patients as satisfactory by d’Aubigné-Postel Score. In the control group the good result was recorded in 9, satisfactory — in 47 and poor — in 4 cases.Conclusion. Meloxicam may be considered as an effective perioperative analgesic in large joints arthroplasty.

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Primary and secondary aortopathy associated with adult congenital heart disease - retrospective study

10.21203/rs.3.rs-25783/v1 ◽

2020 ◽

Author(s):

Ingrid Schusterova ◽

Alzbeta Banovcinova ◽

Marianna Vachalcova ◽

Marta Jakubova ◽

Panagiotis Artemiou

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Root ◽

Congenital Heart ◽

Adult Congenital Heart Disease ◽

Ascending Aorta ◽

Control Group ◽

Adult Congenital ◽

Aorta Dilatation

Abstract Background: Primary and secondary aortopathy are frequently encountered in patients with congenital heart disease. The aim of this study is to present our experience and the incidence of primary and secondary adult CHD-associated aortopathy.Methods. The cohort is comprised of adult patients with congenital heart disease from the registry of the Eastern Slovakia Institute of Cardiovascular Diseases. Data from the last follow-up examinations are included in this study. In the primary and secondary aortopathy group were 35 and 12 patients respectively. As a control group were selected 64 patients with non aortopathy associated congenital heart disease (atrial and ventricular septal defect).Results: Patients with primary and secondary aortopathy had larger ascending aorta/aortic root diameters than the control group (36.28 (26-49) mm vs 30.25 (21-41) mm p=0.000113, 33.82 27-49) mm vs 29.03 (19-38)mm p=0.000366 and 42.1 (30-50) mm vs 30.25 (21-41) mm, p=0.000106, 35.67 (27-48) mm vs 29.03 (19-38) mm, p=0.000119 respectively). Moreover, patients with secondary aortopathy had statistically significant larger ascending aorta diameter compared to the patients with primary aortopathy ( 42.1 (30-50) mm vs 36.28 ( 26-49) mm p=0.030). During the follow-up period, were performed only in 2 patients (one from each group) operations on the aortic root and the ascending aorta due to aortic root or ascending aorta dilatation.Conclusion: More patients with secondary aortopathy had dilated ascending aorta/ aortic root, as well as larger aortic diameters compare to the patients with primary aortopathy. Routine follow-up of these patients with attention to aortic diameter is necessary.

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Use of PlateletRich Autoplasma in Complex Therapy of Knee Osteoarthrosis

N N Priorov Journal of Traumatology and Orthopedics ◽

10.32414/0869-8678-2016-2-40-45 ◽

2016 ◽

pp. 40-45 ◽

Cited By ~ 2

Author(s):

A. I. Gorbatenko ◽

N. O. Kostyanaya

Keyword(s):

Pain Syndrome ◽

Main Group ◽

Control Group ◽

Joint Function ◽

Analog Scale ◽

Number Of Patients ◽

Pain Visual Analog Scale ◽

Inflammatory Drugs ◽

Efficacy Of Treatment

Efficacy of platelet-rich autoplasma (PRA) in treatment of osteoarthrosis was evaluated. Prospective study included 120 patients (83 females, 37 males, mean age 52.8±4.5 years) with clinical and roentgenologic diagnosis of II-IV stage osteoarthrosis by Kellgren-Lawrence classification. The patients from the main group (n=60) were on courses of PRA intraarticular injections (3 injections with 1-2 weeks interval). In the control group the patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and periodically injections of glucocorticoids when indicated. Results were assessed by the verbal efficacy scale, Lequesne index and the pain visual analog scale. Follow up period made up 6 months. Use of PRA enabled to eliminate pain syndrome and improve knee joint function without adverse effects. In 6 months the number of patients who noted the efficacy of treatment was 31% higher in the main group than in the control one. The obtained results allow recommending PRA use for knee osteoarthrosis treatment as an alternative to NSAIDs especially in contraindications to the latter.

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CLINICAL EFFICACY COMPARATIVE EVALUATION OF THE TREATMENT METHODS OF COMBINED DEFECTS AND DEFORMITIES OF THE ZIGOMA AND ORBIT

Ukrainian Dental Almanac ◽

10.31718/2409-0255.2.2021.14 ◽

2021 ◽

pp. 73-81

Author(s):

Yu.V. Chepurnyi ◽

D.M. Chernohorskyi ◽

O.I. Zhukovtseva ◽

A.V. Kopchak

Keyword(s):

Clinical Efficacy ◽

Main Group ◽

Patient Specific ◽

Control Group ◽

Traditional Methods ◽

Actual Problem ◽

Complex Anatomy ◽

And Control ◽

Methods Of Reconstruction

Introduction. Zigoma and orbital defects still become an actual problem of maxilla-facial surgery due to limited possibilities to precise restoration of their complex anatomy. Functional unity of zigoma and orbit in aspects of eyeball support and protection increases requirements to reconstructive precision. The total and subtotal defects are the most difficult for reconstruction when traditional methods of reconstruction demonstrate unconvincing efficiency. Complex anatomy of zigoma and orbit, as combination of convexities, depressions limited an application of free or vascularised bone transplants for precise 3D restoration of the face. Facing this, new possibilities of reconstructed were developed, based on CAD/CAM technologies. Application of patient specific implants (PSI), designed according personal anatomy of the patient and manufactured by additive technologies, open new modalities to reconstruction in orthognatic surgery, cranioplasty and others, demonstrated promising results. So, these achievements and experience possible could be implemented for zigoma reconstruction. The aim of the study was to evaluate and compare clinical efficacy of zigoma and orbital defect treatment with traditional methods of reconstruction. Materials and methods. To reach this purpose, fifty-one patients, who underwent reconstruction procedures regarding zigoma defects, were enrolled to retrospective study. All of them were clinically examined before and after surgery. CT examination was performed before, 1 week and 1 year after surgery in all cases. The patients, included to the study, were divided on two groups – main and control, equal concerning age, sex and anatomical-topographic patterns of the defects. The main group consisted of 27 patients, who underwent zigoma reconstruction with PSI. The rest of the patients, treated with traditional approach (free or vascularised bone grafting, reconstructive plates or reconstruction with temporal muscle), were included to control group. Clinical efficacy was evaluated applying esthetical estimation of experts according to ranking scale. Additionally, frequency of complication and precision of reconstruction according to CT were analysed. Orbital volume differences were calculated for cases of orbital reconstruction. Results. Comparative analysis of esthetical results revealed higher quality of reconstruction in a main group. The patients did not require any further surgical procedures in 66,7% of cases, in contrast, in a control group additional interventions were indicated or performed in 85,3% of patients (p<0,05). Mean rate of aesthetic estimation by experts were 3,15+1,2 in main group and 1,96+0,8 in control. Follow-up period was longer than 12 months for both main and control groups. Mean follow-up were 20,4 ±9,3 and 26,2 ± 13,5 months respectively. During follow-up any kind of complications were observed between the patients of the main group in 14,8% of cases as well in control – 54,2 % (p=0,01). The main complication between the patients of first group was exposure of the implants, which was noted only in 3 cases, and was caused mainly extension of soft tissues above the implant or compromised soft tissue covering due to incomplete vascularisation of the flaps. At the same time the most frequently observed complications of the main group were total or partial resorption of the grafts (two cases), implant exposure (n=7) and limitation of mouth opening. Additionally, deformity of the fixators with bone fragment displacement was noted in 25,0 % cases. Eyeball displacement was defined in 66,7% of all cases. Mean volume difference in main group was 1,5±0,7 см3, when between patients of control it was 2,3±1,2см3 (р=0,032). The frequency of diplopia was equal for both group. Conclusions. The main advantage of PSI application for zigoma reconstruction is the possibility of the precise 3D restoration of its complex anatomy, renewal of the correct position of the zigoma. Relatively to the clinical tasks, PSI could be used as fixator or endoprosthesis separately or with bone graft procedures. In some clinical situations separate application of PSI as endoprosthesis may be consider as effective alternative for free tissue transfer procedures.

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Transient neonatal hypothyroidism: neurological and intellectual features in children aged 5-7 years

Problems of Endocrinology ◽

10.14341/probl11755 ◽

2003 ◽

Vol 49 (6) ◽

pp. 29-32

Author(s):

L. N. Samsonova ◽

Ye. V. Kiseleva ◽

V. P. Zykov ◽

L. L. Naumenko ◽

E. P. Kasatkina

Keyword(s):

Negative Impact ◽

Subsequent Development ◽

Neurological Status ◽

Perinatal Period ◽

Speech Disorders ◽

Control Group ◽

Neonatal Hypothyroidism ◽

The Moment ◽

Tsh Levels

The paper evaluates the perinatal period of the mental, intellectual, and neurological status of children with prior transient neonatal hypothyroidism (TNH). The study involved 60 children aged 5-7years who had been born in Moscow; they had thyroidstimulating hormone (TSH) levels of 20 m U/I. In 56 children of them, spontaneous normalization of TSH levels occurred following 1-6 months by the moment of retesting. Four children in whom no normalization occurred by the moment of serum testing received levothyroxine therapy for 5 months to 4.5 years. A control group comprised 25 children who were parity by all signs and had normal TSH levels at birth. Examination of children included the assessment of their obstetric histories, neonatal TSH, the estimation of the neurological and psychointellectual development at the age of 5-7years. The results have indicated that the children with prior TNH have neurological and psychointellectual features (speech disorders, diminished intellectual operations that characterize logic and image thinking) that may exert a negative impact on the subsequent development of a child and lead to social disadaptation, which makes it necessary to follow up this group of children.

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