Transcatheter aortic valve implantation in patient with mechanical circulation support complicated with postoperative right ventricle failure

В статье представлен клинический случай транскатетерной имплантации аортального клапана (ТИАК) пациенту 71 года с критическим аортальным стенозом в стадии систолической дисфункции с развитием истинного кардиогенного шока. Операция была выполнена в условиях продолжающейся внутриаортальной баллонной контрпульсации. Несмотря на технический успех ТИАК, пациент скончался в раннем послеоперационном периоде при явлениях острой правожелудочковой недостаточности. Авторами проводится анализ особенностей лечения пациента и причин, повлиявших на неблагоприятный исход, а также обсуждается влияние патологии правого желудочка на результаты транс катетерной коррекции аортального стеноза. Clinical case of transcatheter aortic valve implantation (TAVI) in 71 years old male with decompensated critical aortic stenosis in the setting of cardiogenic shock is presented in the paper. The procedure was performed under use of continuous intra-aortic balloon pump. Despite of technical success of TAVI the patient passed away early after procedure with clinical signs of right ventricle failure. The authors analyze the treatment strategy in the context of unfavorable outcome as well as the impact of right ventricle disease on results of TAVI

Fulminant myocarditis: a comprehensive review from etiology to treatments and outcomes

Fulminant myocarditis (FM) is characterized by a rapid progressive decline in cardiac function and a high mortality rate. Since the first report of FM patients in the 1980s, several clinical trials and research studies have been published increasing our knowledge regarding FM. Currently, the diagnosis of FM depends on various techniques including electrocardiography, echocardiography, endomyocardial biopsy, and cardiac magnetic resonance. The development of mechanical circulation support (MCS) devices and progress in our understanding of the pathophysiological mechanisms underlying FM, treatment regimens have evolved from simple symptomatic treatment to a life support-based comprehensive treatment approach. The core mechanism underlying the development of FM is the occurrence of an inflammatory cytokine storm. This review provides a comprehensive account of the current understanding of FM pathophysiology and knowledge regarding its etiology, pathophysiology, treatments, and outcomes.

Cardiac Surgery Nurses Association during the COVID-19 Pandemic

The novel coronavirus disease, which started in China and affected the whole world, has been declared a pandemic by the World Health Organization due to its high rapid spread and mortality rates. The rapid spread of the disease and need for intensive care caused the establishment of pandemic hospitals in Turkey and all over the world. Special healthcare teams have been formed to take part in the management of coronavirus cases in pandemic hospitals. One of the most important team members who take the most responsibility is nurses. Nurses working in different fields took part in the pandemic clinics and intensive care units in this process. Cardiac surgery nurses, who are experienced in critical patient care, mechanical ventilation support, cardiopulmonary resuscitation, mechanical circulation support, and emergency situation management, also served on the pandemic teams. In this article, the duties and responsibilities of cardiac surgery nurses, their problems and needs during the pandemic process, and their contribution to the process were evaluated.

Anticoagulation Strategies for Patients on Mechanical Circulation Support

Anticoagulation strategies for patients with mechanical circulatory support devices (MCSD) remain a daily challenge for clinicians. The balance between thrombosis and bleeding is delicate, with either extreme affecting patient morbidity and mortality. This chapter reviews the evidence for various anticoagulation strategies for patients with left ventricular assist devices (LVAD), extracorporeal membrane oxygenation (ECMO), and total artificial hearts (TAH). Clinical controversies related to tailoring anticoagulation strategies to individual patients addressed in this chapter include adjusting anticoagulation for gastrointestinal bleeding in patients with VADs and monitoring warfarin treatment with chromogenic factor X and with time in the therapeutic range. The direct use of thrombin inhibitors as primary anticoagulation for ECMO and the future of anticoagulation for MCSDs should help prepare clinicians for new research and changes in the field.

PHENOMENON OF DEMIKHOV. In the Sklifosovsky Institute (1960–1986). Scientifc Revolution in Transplantation (1960–1964). Achievements of the USA and the USSR in the feld of transplantation and transplant immunity (1962)

Correspondence to: Sergey P. Glyantsev, Prof., Dr. Med. Sci., Head of the Department of the History of Cardiovascular Surgery at A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery, Head of the Medical History Unit within the Medical History Department at N.A. Semashko National Research Institute of Public Health, e-mail: [email protected] Received: August 08, 2018 Accepted for publication: September 12, 2018 The article presents the evidence of a scientific revolution in transplantology that occurred in the world in 1960-1964 with the shift of the paradigm from the impossibility of homoplastic organ transplants to the hope on their feasibility. It began in 1960 with awarding the Nobel Prize to P. Medawar and F. Burnet for the discovery of artificial immunological tolerance, it had its continuation in 1961–1962 with the advances in experimental transplantation of vital organs undertaken in conditions of mechanical circulation (R. Lower, N. Shumway) and immunosuppression (K. Reemstma), and completed with human transplantations of lung in 1963 and of heart in 1964 (J. Hardy). In those years, the concept of mechanical support for an ill heart by using an implanted mechanical assist device was developed and introduced (1963). But even against that background, V.P. Demikhov's achievements in homologous organ transplantation and the development of biological techniques to overcome tissue incompatibility looked impressive. His highest achievement was the transplantation of a supplemental heart to the dog Grishka in June 1962, and the dog survived with it for 141 days. However, after the discoveries in the field of transplantation immunity, the train of experimental transplantation where V.P. Demikhov was riding, began picking up speed very quickly, and the Soviet surgeons were to jump on its footboard.