scholarly journals Features of Surgical Treatment of Malignant Tumors of the Heart and Ways to Improve Immediate Results

2021 ◽  
pp. 50-55
Author(s):  
Andrii R. Vitovskyi ◽  
Volodymyr V. Isaіenko ◽  
Valentyna M. Ryabytza ◽  
Rostyslav M. Vitovskyi
Keyword(s):  
Surgical Treatment ◽  
Hospital Mortality ◽  
Malignant Tumors ◽  
Mechanical Damage ◽  
Postoperative Mortality ◽  
Cardiac Tumors ◽  
Artificial Circulation ◽  
Results Of Treatment ◽  
Adequate Surgery ◽  
Cardiac Surgeons

To date, the issues of surgical treatment of malignant cardiac tumors (MCT) remain relevant and are of particular interest to cardiac surgeons. Hospital mortality of this group of patients is extremely high (20–30%). Finding ways to reduce early postoperative mortality remains an extremely important task of oncocardiac surgery. The aim. To analyze the causes of early postoperative mortality based on the data of many years of experience in the surgical treatment of MCT and to propose methods for the prevention of early postoperative complications with the improvement of the immediate results of operations. Materials and methods. From 1970 to 01.01.2021, National Amosov Institute of Cardiovascular Surgery has provided surgical treatment of 67 patients with malignant tumors of the heart which amounted to 7.1% of the total number of observed patients with cardiac tumors (949). Of the 67 patients with MCT, 57 (84.9%) were operated using artificial circulation, three operations (4.6%) were emergency. Hospital mortality was 19.4% (13 patients). Results. Microscopic examination of the removed tumors revealed the presence of necrosis zones, their mechanical damage leads to significant intoxication of the patient. To prevent tumor intoxication (cause of postoperative mortality) in the operative and postoperative periods, new methods of combating such a factor of hospital mortality were used, which helped to improve the results of treatment of MCT. Hospital mortality reduced from 33.3% (1970–2001) to 5.5% (last 10 years), as a result of use these measures. Conclusions. Destruction of the tumor during surgery with artificial circulation leads to the entry of a significant number of tumor cells and toxins into the bloodstream, causing tumor intoxication. Improvement of the immediate results of surgical treatment of MCT depends on their timely diagnosis, which allows for adequate surgery with radical removal of the tumor and the use of detoxification measures, significantly reducing surgical mortality.

Surgical Treatment of Primary Cardiac Tumors—Experience with 45 Patients

1995 ◽  
Vol 3 (2) ◽  
pp. 49-52
Author(s):  
Lin Jue Yi ◽  
Chu Shu Hsun ◽  
Lee Yuan Teh ◽  
Wang Shoei Shen ◽  
Lin Fang Yue ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Left Atrium ◽  
Malignant Tumors ◽  
Thyroid Tissue ◽  
University Hospital ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Incomplete Resection ◽  
Long Term Result ◽  
Primary Cardiac Tumors

Primary cardiac tumors are very rare and the majority of them are histologically benign and surgically curable. During a 30-year period from 1963 to January 1993, 45 cases of primary cardiac tumors were surgically excised at the National Taiwan University Hospital, representing 0.52% of 8,695 open heart surgical cases during the same period. In this series, 42 cases (94%) were benign tumors; 39 (88%) were myxoma (30 female, 9 male), and 32 (82%) originated in the left atrium. None were discovered in the left ventricle. In all but the first 6 cases, tumors in patients with myxoma in the left atrium were successfully excised by the transseptal approach. There were 3 patients with rare benign tumors: intracardiac goiter, rhabdomyoma, and hemangioma respectively. The intracardiac goiter was completely excised with no ectopic thyroid tissue after operation and the other 2 received palliative resection. The latter 2 patients suffered no recurrence. Rhabdomyosarcoma, leiomyosarcoma and malignant lymphoma were noted in one patient each, all of whom died of low cardiac output in the early postoperative course. In our experience, the majority of primary cardiac tumors were benign and located in the left atrium. The long-term result of surgical treatment of benign cardiac tumors is excellent, even incases of incomplete resection, while the results from surgical treatment of malignant tumors is poor.

scholarly journals Surgical Treatment of Heart Mixomas: the Analysis of 10 Years’ Experience

2021 ◽  
Vol 10 (2) ◽  
pp. 385-392
Author(s):  
V. V. Vladimirov ◽  
A. I. Kovalev ◽  
A. V. Redkoborody ◽  
V. V. Sokolov ◽  
N. M. Bikbova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Well Being ◽  
Surgical Removal ◽  
Cardiac Tumors ◽  
Heart Neoplasms ◽  
Results Of Treatment ◽  
Heart Tumors

Introduction. Primary cardiac tumors are rare, and the autopsy detection rate does not exceed 0.003%. Approximately 80% of primary heart tumors are benign, 50% of them are myxomas. Diagnosis of cardiac tumors at present in the presence of transesophageal echocardiography is not difficult in most cases. Surgical treatment of mixomas became possible after the introduction of open-heart surgery under cardiopulmonary bypass into clinical practice. After verification of the tumor, its surgical removal is indicated. In the practice of large cardiac surgery clinics, the experience of radical treatment of heart neoplasms is relatively small; therefore, the analysis of tactical approaches and results of operations in this pathology is of absolute interest.Aim of study. To present an analysis of 10 years’ experience in surgical treatment of cardiac mixomas. Material and methods The results of treatment of 58 patients with myxomas who underwent surgical removal of the neoplasm of the heart are presented.Results. Hospital mortality after surgical removal of myxoma was 1.7%, 1 patient died. All patients, we have the long-term period data about, noted a significant improvement in well-being, a decrease or disappearance of dyspnea at rest and/or during exertion, and no recurrence of myxoma was noted. Conclusion. The data obtained indicate, on the whole, good immediate results and high quality of life of patients in the long-term period operated on for heart mixomas. 

COMBINATION OF ESOPHAGEAL ATRESIA WITH TRACHEOESOPHAGEAL FISTULA AND DUODENAL ATRESIA: TREATMENT ANALYSIS OF FIFTEEN PATIENTS

2021 ◽  
Vol 100 (6) ◽  
pp. 45-53
Author(s):  
I.N. Khvorostov ◽  
◽  
N.K. Barova ◽  
S.V. Minaev ◽  
M.A. Akselrov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Esophageal Atresia ◽  
Gestational Age ◽  
Tracheoesophageal Fistula ◽  
Postoperative Mortality ◽  
Duodenal Atresia ◽  
Two Stage ◽  
Results Of Treatment ◽  
Esophageal Anastomosis ◽  
Overall Mortality

The combination of duodenal atresia (DA) with esophageal atresia with tracheoesophageal fistula (EA-TEF) is a rare pathology, the frequency of which ranges from 1% to 6% of all cases of EA. Surgical treatment of the DA+EA-TEF combination always causes significant difficulties, primarily in determining the timing and stages of surgical correction. Objective of the study: to evaluate the results of treatment with a combination of DA+EA-TEF to determine the effective tactics of surgical treatment. Materials and methods of research: a retrospective, nonrandomized, uncontrolled, multicenter study was carried out. The work is based on the results of treatment of 15 newborns – 6 (40%) boys, 9 (60%) girls with a combination of DA+EA-TEF, who were treated in clinics of 6 university centers for pediatric surgery in the Russian Federation in 2015–2021. Simultaneous operations (SIMOPs) were performed in 10 (60%) patients, two-stage operations (TO) – in 5 (40%) newborns. The following criteria were taken into account: the period of antenatal (weeks) and postnatal (days) of establishing the diagnosis of obstruction of the gastrointestinal tract (GIT), gestational age (weeks), birth weight (g), weight at the time of surgery (g), type of concomitant pathology , sequence and methods of surgical treatment, terms of complete enteral feeding (days), outcomes of operations and reasons for unsatisfactory outcomes. The average gestational age of children who underwent SIMOPs was 35.1 weeks. (Q1 – 31.5, Q3 – 39; Me – 37; SD – 5.1; min/max – 25–40; 95% CI: 31.1–39.0) versus 29.8 weeks. at DO (Q1 – 29, Q3 – 30.5; Me – 30; SD – 1.0; min/max – 28–31; 95% CI: 28.4–31.6) did not differ statistically significantly (р=0.083). The mean body mass values did not have statistically significant differences (p=0.081) and amounted to 2224 g (Q1 – 1410, Q3 – 2930; Me – 2665; SD – 890.8; min/max – 760–3260; 95% CI: 1556–2926) for SIMOPs, versus 1322 g (Q1 – 1165, Q3 – 1450; Me – 1380; SD – 196; min/max – 980–1450; 95% CI: 1078.4–16565) in the TO group. Results: the average duration of SIMOPs was on average 144.4 min (Q1 – 125, Q3 – 155; Me – 147.5; SD – 22; min/max – 120–190; 95% CI: 1321–159.3), TO – 147.0 (Q1 – 125, Q3 – 172; Me – 140; SD – 33.4; min/max – 120–205; 95% CI: 126–178.6). The sequence of surgical correction of defects in SIMOPs in 8 (53%) patients consisted of thoracotomy, ligation of the TEF, direct anastomosis of the esophagus and the imposition of duodeno-duodenoanstomosis (DDA). In one case, DDA was selected as the first operation, which was supplemented with Kader gastrostomy followed by thoracotomy, ligation of the TEF and anastomosis of the esophagus after elongation according to I. Livaditis. In one patient, after thoracotomy and ligation of the TEF in connection with an insurmountable diastasis of the esophagus, a cervical esophagostomy (CE), duodenojejunoanastomosis (DEA) and a gastrostomy according to Kader were applied. In a two-stage correction (TO), the first operation in 3 patients was DDA (20%), supplemented in one case (7%) with Kader gastrostomy, and the second stage after 2 days performed thoracotomy with the elimination of TEF and EA. In 2 (13%) newborns, the first stage was thoracotomy, elimination of TEF and EA, followed by imposition of DDA 2 days later. In one case, due to an insurmountable diastasis of the esophagus after thoracotomy and ligation of the TEF, intrathoracic elongation of the esophagus according to Foker with delayed anastomosis of the esophagus (on the 7th day) and laparoscopic fundoplication according to Nissen (at 5 months) were performed. The duration of hospitalization did not statistically significantly depend on the chosen method for correcting the combination of DA+EA-TEF (p=0.79) and averaged 28.4 days for SIMOPs (Q1 – 16, Q3 –34.5; Me – 26; SD – 21.4; min/max – 5.0–79; 95% CI: 17.6–42.4), and for TOs – 27,2 days (Q1 – 21, Q3 – 33; Me – 28; SD – 7.1; min/max – 19–38; 95% CI: 27.2–33). In the group of patients with SIMOPs, 2 deaths (13%) were recorded on the 5th and 7th days after surgery due to progressive multiple organ failure and intractable pulmonary hypertension. In one case (7%), a lethal outcome was recorded 8 months after primary surgery due to progressive cardiovascular failure. Early postoperative mortality after SIMOPs was 20%, overall mortality was 30%. In the TO group, 3 (20%) deaths were recorded: 2 in the early postoperative period (on day 3 and day 19) and one at the age of 3 months of life. Early postoperative mortality after TO was 40%, overall mortality – 60%. Conclusion: it is preferable to choose the ligation of the TEF as the first operation and, if the child's condition allows, to impose an esophageal anastomosis and restore duodenal patency, followed by a nasogastric tube through the esophageal anastomosis into the stomach. If, after ligation of the TEF, the patient's cardiorespiratory status does not stabilize, it is possible to restore the patency of the esophagus and pass the probe into the stomach without imposing a gastrostomy, which will allow the patient to be further treated as an isolated DA, and the operation to restore the patency of the duodenum is delayed. In the presence of insurmountable diastasis, the use of esophageal elongation technology with subsequent delayed EA is justified.

Surgical Treatment of Primary Cardiac Tumors

1997 ◽  
Vol 5 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Gu Chun Jiu ◽  
Bao Wei Ke ◽  
Guo Bin Xun ◽  
Yuan Hong ◽  
Xiu Zhong Yi
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Right Atrial ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Long Term Result ◽  
The Right ◽  
Medical University ◽  
Primary Cardiac Tumors

During a 16-year period from 1980 to 1996, 101 patients with primary cardiac tumors underwent surgery at the 1st Affiliated Hospital of China Medical University, which represented 2.44% of 4142 open-heart surgical cases during this period. Most tumors were benign; 94 were myxomas, 2 were fibromas, and 1 was a hemangioma. Three myxomas were in the right atrium and 91 were in the left atrium. The 4 malignant tumors comprised 2 mesothelioma, 1 histiocytoma, and 1 right atrial malignant myxoma. All benign tumors were completely excised with 4.95% mortality. Only 1 malignant tumor was completely excised. In our experience, the long-term result of surgical treatment of benign cardiac tumors is excellent, whereas the prognosis for patients with malignant cardiac tumors is very poor. The incidence of malignant tumors was lower than in other studies.

scholarly journals Comparative Evaluation of Aortic Valve Replacement Methods in Patients Over 70 with Aortic Stenosis

2018 ◽  
Vol 7 (3) ◽  
pp. 227-233 ◽  
Author(s):  
V. V. Sokolov ◽  
M. V. Parkhomenko ◽  
A. I. Kovalyov ◽  
V. V. Vladimirov ◽  
O. L. Shiryayeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Hospital Mortality ◽  
Heart Diseases ◽  
Surgical Techniques ◽  
Results Of Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundAs life expectancy and quality of health improve, more and more people reach old age, and so does the number of heart diseases. One of the most urgent problems among elderly patients is degenerative stenosis of the aortic valve (AV). The conservative treatment of symptoms of chronic heart failure with AV stenosis improves the patient’s condition only for a while, whereas surgical treatment such as replacement of AV is recognized as the main effective method of treating a defect. Recently, alternative technologies for prosthetic AV have been developed, aimed at reducing adverse effects of artificial circulation (AC) in high-risk patients and minimizing the scope of surgical intervention.Aim of studyThe aim of the study was to evaluate the immediate results of surgical treatment of aortic stenosis using different methods in patients over 70.Material and methodsThe article presents the results of treatment of 64 patients over 70 with isolated AV stenosis, operated with different surgical techniques from July, 2016 to January, 2018. All patients were divided into three groups, differing in the severity of the initial condition and the method treatment. Group 1 (transcatheter implantation of the prosthetic AV, EuroSCORE II — 21.81%) consisted of 19 patients, Group 2 (non-suture implantation of a Perceval prosthetic valce under the AC, EuroSCORE II — 13.81%) consisted of 13 patients and Group 3 (“standard” prosthetics, EuroSCORE II — 9.89%) consisted of 32 patients.ResultsIn Group 1, two patients died, the hospital mortality was 10.5%. In Group 2 and Group 3, one patient died, the hospital mortality was 7.6 and 3.1%, respectively. Implantation of a permanent pacemaker was required in three patients (15.7%) from the TAVI group after installation of Medtronic Core Valve and two patients (15.3%) from the Perceval group.ConclusionThe obtained results of AV replacement by various methods allowed to expand indications for the management of AV stenosis in patients of the older age group with a high surgical risk of operation under AC conditions who had not previously been considered candidates for surgical treatment of aortic malformation due to the age and severity of the concomitant pathology.

scholarly journals Surgical treatment of patients with descending purulent mediastinitis

2021 ◽  
Vol 26 (4) ◽  
pp. 118-123
Author(s):  
I.M. Shevchuk ◽  
S.S. Snizhko
Keyword(s):  
Surgical Treatment ◽  
Pleural Cavity ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Complete Removal ◽  
Main Group ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical ◽  
Surgical Tactics

The aim of the study was to improve the results of treatment of patients with descending purulent mediastinitis by means of individualized surgical tactics with the priority use of minimally invasive surgical interventions and developed methods of drainage of the mediastinum and pleural cavity. Examination and treatment of 73 patients with descending purulent mediastinitis receiving treatment in the department of thoracic surgery of Ivano-Frankivsk regional clinical hospital was carried out. Treatment of patients in the main group included intramediastinal administration of antibiotics, the use of the developed method of cascade drainage of the mediastinum and pleural cavity, the priority use of video-assisted thoracoscopy and surgical tactics aimed at anticipating the spread of the purulent process in the mediastinum. The rapid and reliable decrease in the indices of endogenous intoxication in the main group confirms the effectiveness of the developed tactics of surgical treatment of patients with mediastinitis, adequate sanation of purulent mediastinatis, complete removal of the purulent substrate from the mediastinum and pleural cavity. The developed tactics of surgical treatment of purulent mediastinitis allowed reducing the overall postoperative mortality from 26.3% in the comparison group to 11.4% in the main group of patients.

FEATURE OF SURGICAL TREATMENT OF GASTRODUODENAL BLEEDING

Vestnik ◽  
2021 ◽  
pp. 215-223
Author(s):  
А.Т. Джумабеков ◽  
Р.Е. Каштаев ◽  
С.М. Жарменов ◽  
С.Ж. Жанбырбаев ◽  
А.Ж. Артыкбаев ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Inpatient Treatment ◽  
Central City ◽  
Postoperative Mortality ◽  
Endoscopic Hemostasis ◽  
Clinical Hospital ◽  
Results Of Treatment

Применение принципов комплексного использования эндоскопического гемостаза и использование эрадикационной, антисекреторной терапии у больных с гастродуоденальным кровотечением, находящихся на стационарном лечении в ЦГКБ г. Алматы, позволило улучшить результаты лечения больных, значительно снизить количество осложнений после операций, сократить частоту как общей, так и послеоперационной летальности. The application of the principles of the integrated use of endoscopic hemostasis and the use of eradication, antisecretory therapy in patients with gastroduodenal bleeding who are inpatient treatment at the Central City Clinical Hospital of Almaty, made it possible to improve the results of treatment of patients, significantly reduce the number of complications after surgery, and reduce the incidence of both general and postoperative mortality.

scholarly journals Staged surgical treatment of cholangiogenic abscesses of the liver

2020 ◽  
pp. 20-23
Author(s):  
V. V. Boyko ◽  
V. M. Lykhman ◽  
D. A. Miroshnichenko ◽  
A. A. Merkulov ◽  
S. V. Tkach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Mortality ◽  
Treatment Method ◽  
Stage Ii ◽  
Abscess Cavity ◽  
Controlled Drainage ◽  
Results Of Treatment ◽  
Liver Abscesses ◽  
Single Lumen

The aim of the work: to improve the results of treatment of patients with cholangiogenic liver abscesses by means of staged treatment methods using minimally invasive interventions. Materials and Methods. 82 patients with cholangiogenic liver abscesses aged 21 to 80 years who underwent 130 operations were examined and treated. The main group consisted of 40 (48.4 %) patients who underwent ultrasound-controlled drainage of abscess cavities (stage I), followed by removal of the source of cholangiogenic abscesses (stage II). The comparison group consisted of 42 (51.6 %) patients who underwent rehabilitation and drainage only with laparotomy access. Results and Discussion. Minimally invasive methods of surgical treatment included ultrasound-controlled drainage with simultaneous rehabilitation of abscess cavities. The dimensions of the cavities averaged (150±23.3) cm³. One drainage was used to drain the liver abscess with a diameter of up to 10.0 cm. When the diameter of the abscess was more than 5.0 cm, drainage was carried out by two single-lumen tubes followed by suction-flow washing of the abscess cavity. Monitoring the standing of the drainage and reducing the cavity of abscesses was carried out on 3, 7, 14 days after setting. The drainage tube was removed after the disappearance of the cavity according to ultrasound and control fistulography, which coincided with the normalization of the general condition and body temperature, the disappearance of signs of purulent intoxication. Duration of drainage averaged from 7 to 30 days (an average of 15.2). The proposed treatment method is not very traumatic, the ability to control the effectiveness of the treatment, and most importantly – positive results in 87 % of patients. Second stage in 38 (95 %) was performed laparoscopic cholecystectomy of technical features. The optimal duration of stage II was considered (13±3) days after extraction of the drainage. In the diagnosis and treatment of cholangiogenic liver abscesses, it is necessary to use puncture ultrasound-controlled drainage methods. The stage-by-stage treatment of cholangiogenic liver abscesses with rehabilitation of the abscess cavity made it possible to reduce the incidence of sepsis from 9.5 to 2.5 %, reduce postoperative mortality in extremely severe patients to 2.4 %, and develop complications by 7.3 %.

scholarly journals Cardiac masses due to tumors (diagnosis, clinical manifestations and surgical treatment)

2014 ◽  
Vol 95 (6) ◽  
pp. 806-810 ◽  
Author(s):  
D L Kranin
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Low Grade ◽  
Imaging Results ◽  
Valvular Heart Diseases ◽  
Cardiac Myxomas

Aim. To summarize the experience on the diagnosis and surgical treatment of primary benign and malignant cardiac tumors. Methods. The paper describes 37 clinical observations of endocavitary primary benign and malignant cardiac tumors: 26 (70.3%) cases of cardiac myxoma, 5 (13.5%) - rhabdomyosarcoma, 2 (5.4%) - angiosarcoma, 1 (2.7% ) - leiomyosarcoma, 1 (2.7%) - fibrosarcoma, 1 (2.7%) - liposarcoma. Patients were 15 (40.5%) males and 22 (59.5%) females aged 18 to 65 years. Endocavitary cardiac tumors were diagnosed by noninvasive tests: echocardiography, computed tomography, magnetic resonance imaging. Results. Patients with primary benign and malignant cardiac tumors had variable clinical manifestations. Symptoms of astenoneurotic syndrome, auscultatory and cardiophonographic signs simulating acquired or congenital valvular heart diseases, which often have a positional relationship; low-grade fever of unknown origin, weight loss were registered. Paraneoplastic syndrome was characterized by an increase in erythrocyte sedimentation rate, leukocytosis, monocytosis, dysproteinemia, polycythemia, hypochromic anemia, increased levels of C-reactive protein. Surgical excision of 25 cardiac myxomas and 8 malignant tumors of the heart was performed with cardiopulmonary bypass, pharmacological cardioplegia and general hypothermia. In 1 case the tumor resection was combined with coronary artery bypass grafting. In 3 patients suffering from malignant tumors, explorative thoracotomy was performed. Surgical revision, emergency and planned microscopic studies of removed cardiac tumors allowed to establish the final clinical diagnosis. Hospital mortality among patients operated for cardiac myxomas was 4.0%, for cardiac malignant tumors - 27.3%. Conclusion. Timely surgical treatment of patients with primary cardiac benign tumors (myxomas) leads to recovery and is accompanied by a relatively low mortality; better results of patients with cardiac endocavitary tumors treatment depend on the early detection and timely radical surgical excision.

scholarly journals Immediate and Long-Term Results of Treatment of Aneurysms of Ascending Aorta and Aortic Arch and Substantiation of Tactical Approaches to the Treatment Based on the Obtained Results

2021 ◽  
pp. 69-75
Author(s):  
Vitalii І. Kravchenko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Hospital Mortality ◽  
Aortic Arch ◽  
Ascending Aorta ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Long Term Follow Up

Acute aortic dissection is a formidable disease. Its prevalence increases due to the population aging, as well as wider awareness of physicians about this pathology. The aim. To analyze immediate and long-term results of surgical treatment of aneurysms of ascending aorta and aortic arch and to determine optimal methods of correction of these lesions in order to improve the results of surgical treatment. Materials and methods. This was a comparative analysis of immediate and long-term treatment outcomes in 419 patients with aneurysms of ascending aorta and aortic arch. A comparative analysis of the results of treatment of two groups of patients was performed: the comparison group of 157 people operated before 2013, and the main group of 262 patients operated since 2013 using modified methods of aortic surgery. Results. The study showed significant reduction in the left ventricular dilatation according to echocardiography and satisfactory postoperative course in patients of both groups. Patients with valve-sparing aortic prosthetics had better results than those who underwent valve replacement surgery. Hospital mortality decreased from 17.2% to 5.3%. Analysis of long-term results showed that supracoronary aortic prosthetics with aortic valve plasty and elimination of the intimal tear zone make it possible to carry out effective aortic reconstruction. Due to events in the long run, regular lifelong monitoring is required. The analysis also showed that individualized approach to the choice of surgical tactics for the correction of aortic insufficiency in patients with aortic root and ascending aortic pathology allows to achieve comparable results in the immediate and long-term follow-up. Despite the complexity of the applied correction methods, the developed methods of surgical treatment of ascending aortic aneurysm (AAA) and aortic arch aneurysm and methods of protection of brain and visceral organs allowed to keep hospital mortality and the number of complications at the same level corresponding to one of the best world results. This gives hope for a good result in the long-term follow-up. Conclusions. Aneurysm of ascending aorta and aortic arch is a formidable life-threatening disease, and its only non-alternative treatment option is surgery. The optimized approach to the treatment of patients in the main group allowed to obtain better immediate and long-term results of surgical treatment and reduce postoperative complications from 34.4% to 8.4% and hospital mortality from 17.2% to 5.3%. Comparative analysis of long-term results in the studied groups showed more encouraging indicators of quality of life and life expectancy in patients when using modified surgical techniques, protection of the brain and visceral organs. We hope to get a final assessment of these data in the further study of the condition of these patients in the long-term follow-up.

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