[Visualization of sinus node arteries by multislice spiral computed tomography coronary angiography].

Objective: To assess the capabilities of multislice spiral computed tomography coronary angiography (MSCT-CA) to visualize the anatomy of the sinus node artery (SNA).

Material And Methods: The retrospective analysis of coronary artery examinations covered 46 patients with the referral diagnosis of coronary heart disease. MSCT-CA showed no evidence of coronary artery stenosis.

[Structural features of cardiomyocytes in the atrialized right ventricle in patients with Ebstein anomaly].

Intraoperative biopsy specimens were used to analyze the sizes and ultrastructure of cardiomyocytes (CMC) in the atrialized right ventricle (ARV) versus those in the right ventricle (RV) and right atrium (RA) in 32 patients aged 9 months to 57 years with Ebstein anomaly. The mean CMC diameter in ARV, RV, and RA did not differ significantly in patients less than 10 years; that was equal in ARV and RV, but higher in RA in patients over 10 years of age. No specific atrial granules were found in the CMC of ARV, RV, and RA; but T system channels and multiple intercalated disks were encountered significantly more frequently than in the RA cells.

[Clinical and morphological parallels in mitral valve disorders in infants with atrioventricular defect].

Mitral valves tissue samplings from children with complete (13 patients) and partial (6 patients) atrioventricular defects at the age of from I month to 3 years old were examined. The biopsy material was received during the repeat surgical operation on mitral valve, performed due to residual mitral valve regurgitation grade 3-4 at the period of time from 2 days to 1 year after radical defect correction. On histological examination the areas of myxomatous tissue degeneration occupying more than 50% of mitral valves surface were found in 6 (32%) of the 19 patients.

[Modern approaches to diagnostics and surgical correction of brachiocephalic arteries disorders in patients with ischemic heart disease].

The main causes of morbidity in Russia are ischemic heart and cerebrovascular disease. The mortality rate of these conditions accounts for almost 50% of all the lethality causes of the Russian population. The frequency of associated coronary and brachiocephalic arteries disorders varies from 18 to 54%.

[First experience with monitoring somatosensory and motor evoked potential during operations on the thoracic and thoracoabdominal portions of the aorta].

Specialists in Russia have recently gained vast experience in operations on the thoracic and thoracoabdominal portion of the aorta; however, studying evoked potentials for preventing lesions of the spinal marrow have not been studied in any clinic. The authors report herein their first experience in Russia in studying the function of the marrow during operations on the aorta followed by detailed description of the technique of registering evoked potentials. From June 2010 to January 2011, specialists of the Arterial Pathology Department of the A.

[Remote results of open interventions in treatment of abdominal aortic aneurysms].

Analysed herein are the results of treating a total of 471 patients operated on at the Department of Surgical Treatment for Arterial Pathology of the Research Centre of Cardiovascular Surgery named after A. N. Bakulev under the Russian Academy of Medical Sciences for an aneurysm of the infrarenal portion of the abdominal aorta.

[Modern approach towards surgical treatment of coronary heart disease in diabetic patients].

In the recent years there has been registered an increase in diabetes mellitus (DM) morbidity, especially among able-bodied citizens. The steady increase in amount of DM patients inevitably leads to the increase in the amount of diabetic CHD patients--candidates for the surgical myocardial revascularization. This article contains analysis of choice of myocardial revascularization technique in patients with CHD and concomitant DM.

[Surgical and interventional treatment of atrial fibrillation].

Results of surgical and interventional treatment of atrial fibrillation with the use of different methods are discussed. Original data are presented. Relative efficiency of radiofrequency, microwave, and cryogenic ablation is considered.

[The use of assisted circulation in cardiosurgical clinic].

The first experience with the use of different artificial circulation systems for the treatment of critical cardiac insufficiency in A. N. Bakulev Research Centre of Cardiovascular Surgery is described.

[Correction of ischemic atrioventricular insufficiency as a component of surgical remodeling of post-infarction heart in patients with ischemic dilatation cardiomyiopathy].

Patients with ischemic dilatation cardiomyopathy are most difficult to control symptoms of cardiac insufficiency (CI). Analysis of survival, results of cardiac chamber remodeling, and severity of CI in 192 patients showed that the optimal outcome of the treatment is on the average achieved in case of surgical revascularization combined with correction of ischemic atrioventricular insufficiency.

[Comparative evaluation of efficacy of intracoronary shunts in minimally invasive myocardial revascularization].

Intracoronary shunts (IS) are devices for maintaining distal coronary blood flow when placing anastomoses with coronary arteries. The use of IS ensures functional and electrical stability of myocardium during its revascularization on the working heart. There are reports of endothelial damage by IS leading to dysfunction of coronary shunts.

[Modern approaches to surgical treatment of patients with complicated and combined forms of coronary heart diseases].

The incidence of atherosclerotic lesions in coronary arteries combined with other vascular problems has been increasing during the last years. Hence, a rise in the number of patients with coronary heart disease, candidates for surgical myocardial revascularization. This paper reviews the history of surgical treatment of combined lesions of coronary and peripheral arteries and presents original criteria developed in A N Bakulev Research Centre of Cardiovascular Surgery for the choice of surgical strategy to treat multifocal atherosclerosis and postinfarction left ventricular aneurysm.

[Results of bidirectional cavapulmonary shunt operation without cardiopulmonary bypass in children with complicated congenital heart defects during the first year of life].

The authors present results of bidirectional cavapulmonary shunt operation without cardiopulmonary bypass for the treatment of complicated congenital heart defects. Temporary blood shunting during surgical intervention enables cavapulmonary anastomosis to be created without making resort to artificial circulation (AC) and limitation on the time of superior vena cava occlusion. The proposed method is free from additional risks and excludes negative effects of AC.

[Hybrid surgical palliation for hypoplastic left heart syndrome in newborn infants].

Hybrid surgery for the treatment of hypoplastic left heart syndrome was undertaken in 19 newborn infants from December 2007 to January 2009. An original method was used with the approach from posterolateral thoracotomy bypassing pulmonary arteries from the transverse pericardial sinus. The survival rate was 84%.

[Possible complications of catheter ablation of atrial fibrillation].

Atrial fibrillation (AF) is the commonest form of disturbed cardiac rhythm. Hundreds of thousands of AF ablations are annually performed worldwide using different energy sources. One of the most popular methods is radiofrequency catheter ablation (RFA).

[The history of Wolf-Parkinson-White syndrome and evolution of surgical methods for its management].

Wolf-Parkinson-White syndrome (WPW syndrome) affects roughly 1% of the population. It usually occurs in subjects with normal heart function but may combine with congenital cardiac failure and cardiomyopathy. Paroxysmal tachycardia is recorded in 40-80% of he WPW patients, largely in the form of reciprocal tachycardia related to circulation of excitation in the atrioventricular junction and Kent's bundle.

[Planning advanced research in the framework of goal-oriented scientific programs and their role in the development of cardiovascular surgery in the Russian Federation].

The role of goal-oriented scientific programs in the development of cardiovascular surgery is illustrated including its early and mature periods. Conceptual planning of such programs and their importance for the elaboration of new promising methods of diagnosis and surgical treatment of cardiovascular pathology are analysed in the context of organization of modem high-technology cardiosurgical care.

[Expert assessment of operations' complexity and its interrelationship with lethal outcomes and duration of treatment].

The aim of the work was to carry out expert assessment of complexity of operations and to study interrelationship of the average score of complexity of the interventions with lethal outcome and duration of treatment in the Intensive Care Unit (exemplified by comparison with the outcomes of operations on cardiac valves performed in 2009 in the setting of artificial circulation in adult patients). Complexity was assessed by a total of 13 cardiovascular surgeons specialized in operations aimed at correcting valve defects (4 of them were from the A. N.

[Surgical treatment of Taussig-Bing anomaly in children in the first year of life].

The history of surgical treatment, clinical features, and main variants of correction of Taussig-Bing anomaly in children during the first year of life is briefly reviewed including original data obtained in the Department of Urgent Surgery of newborn and first-year infants, A. N. Bakulev Research Centre of Cardiovascular Surgery for the period of 2000-2006.

[Implantable cardioverters-defibrillators: prevention of sudden death].

The paper is devoted to review of results of clinical application of implantable cardioverters-defibrillators (ICD) as a method of prevention of sudden cardiac death (SCD). In this work definition, epidemiology, mechanism, and nosological causes of SCD are presented, followed by historical review of development of defibrillation, cardioversion, creation and improvement of implantable antiarrhythmic devices. Analysis of main clinical trials of efficacy of ICD in primary and secondary prevention of SCD has been conducted.

[Causes of second operations after surgical treatment of congenital tricuspid valve abnormalities].

Main causes necessitating replacement of tricuspid valve (TV) prosthesis were calcinosis and infectious endocarditis of the bioprosthesis. Second operations after primary reconstructive surgery for the replacement of TV prosthesis were needed when medical indications did not fully justify the use of valve salving surgery by the Danielson's method and in case of procedural errors during surgery by the method of Carpentier in the initial period of mastering these approaches.

[Atrial fibrillation: new approaches to intervention treatment].

New technologies for electrophysiological diagnosis of atrial fibrillation make possible elucidation of the mechanisms of the development and maintenance of arrhythmia and detection of the so-called arrythmogenic pulmonary veins. Radiofrequency ablation procedure (especially at the posterior wall of the left atrium) includes, besides electrical isolation of pulmonary veins, partial (parasympatic) denervation of the heart that also influences the efficiency of interventional treatment of atrial fibrillation (AF). Modem methods of interventional treatment help to efficaciously manage paroxysmal AF in 85-90% of the patients by means of radiofrequency ablation (RIA) of pulmonary veins.