The authors report the clinical case of secondary Takotsubo syndrome developed after transcatheter aortic valve replacement that was performed in compassionate manner in female patient with combination of congenital ventricular septal defect and acquired severe aortic stenosis. In the teams view, Takotsubo syndrome was triggered with profound changes of intracardial hemodynamics subsequent to iatrogenic impairment of preexisting interventricular shunt.
View Article and Find Full Text PDFThe most common heart valve defect among the elderly and senile is aortic valve stenosis. The traditional method of treating severe aortic valve stenosis is open surgery to replace aortic valve. At the same time, a more modern, minimally invasive method of correcting aortic stenosis is transcatheter aortic valve implantation (TAVI).
View Article and Find Full Text PDFAim To evaluate 30-day results of the transcatheter correction of degenerative aortic stenosis using a novel self-expandable valve, PorticoTM.Material and methods Transcatheter aortic valve implantation (TAVI) was performed in 42 patients with an intermediate surgical risk (mean age, 74.3±6.
View Article and Find Full Text PDFA 58-year-old female patient with severe chronic heart failure and mitral regurgitation receiving an optimal drug therapy was implanted with an Optimizer Smart device for modulation of cardiac contractility and underwent transcatheter mitral plasty using a MitraClip system. The complex therapy resulted in a significant clinical improvement and beneficial dynamics of echocardiographic parameters.
View Article and Find Full Text PDFAim: The study was aimed at assessing the in-hospital results of aortic arch endoprosthetic repair using different variants of endovascular supraaortic debranching.
Patients And Methods: The analysis included 27 patients subjected within the framework of aortic arch endoprosthetic repair to various types of supraaortic endobranching, including the technique of parallel prostheses and implantation of fenestrated stent grafts. We analysed the clinical and morphological status of patients prior to operation, peculiarities of the intervention (type of debranching and Ishimaru's classification zones in which the reconstruction was performed) and in-hospital results of treatment.
This article presents a clinical case of successful transcatheter aortic valve implantation in an elderly patient with critical aortic stenosis at the stage of systolic dysfunction with development of genuine cardiogenic shock. The role of transcatheter aortic valve implantation in the pathogenetic treatment of acute heart failure due to decompensated aortic stenosis was briefly discussed.
View Article and Find Full Text PDFRisk stratification among patients with aortic stenosis remains inadequate, and there is a clinical need for the correct identification of high-risk patients who would benefit from aortic valve intervention before developing left ventricular decompensation. Since the publication of the results of the PARTNER study, transcatheter aortic valve implantation (TAVI) has become the method of choice for aortic valve stenosis in inoperable patients and is a real alternative to conventional surgical replacement of the aortic valve in high-risk patients. In planning TAVI and postoperative monitoring of a patient from imaging methods, the leading role is played by echocardiography and multispiral computed tomography.
View Article and Find Full Text PDFCoronary arteries obstruction associated with transcatheter aortic valve implantation (TAVI) may occur either during the procedure or after it. In the latter coronary obstruction can be further divided into early (7 days after procedure) or delayed one (7 days). Delayed coronary obstruction (DCO) is referred as a rare but devastating complication after TAVI and is associated with the extremely high mortality.
View Article and Find Full Text PDFCritical illness - related corticosteroid insufficiency (CIRCI) is associated with elevated level of circulating biomarkers of inflammation, pro - coagulant effects, deterioration of systemic inflammatory response syndrome (SIRS) and, consequently, prolonged in - hospital stay and increased mortality of intensive care patients. Incidence of CIRCI widely varies depending on specific patient's population and applied diagnostic thresholds being as high as 30% among postoperative patients on inotropes. CIRCI is a complex clinical and pathophysiological condition with substantial influence on immediate survival and prognosis.
View Article and Find Full Text PDFAnalysed herein are the data of scientific literature over several last years concerning the use of contrast-enhanced ultrasonography (CEUS) of the abdominal portion of the aorta. Based on the results of Russian and foreign studies, the authors analyse feasibility of using CEUS in various pathological conditions of the aorta, as well as sensitivity, specificity, and prognostic value of the method. Also discussed are advantages and limitations of CEUS compared with other imaging techniques.
View Article and Find Full Text PDFThe problem concerning diagnosis and treatment of abdominal aortic aneurysms (AAA) is important today because of a high proportion of this pathology within the structure of population morbidity and mortality, with a tendency of these indices to increase, as well as high lethality rates in development of complications. Endovascular treatment of aortic aneurysms is one of the most rapidly developing methods of treatment in vascular surgery. Over the last two decades this type of treatment has been playing an important part in the armamentarium of the vascular surgeon and is often considered as primary treatment of patients with AAA of infrarenal localization.
View Article and Find Full Text PDFPurpose: to assess rate of complications after transcatheter aortic valve implantation (TAVI).
Material And Results: Our study included 99 patients who underwent TAVI. Frequent complications were: bleeding not requiring surgical hemostasis (17.
Transaortic approach represents an alternative variant of transcatheter aortic valve implantation (TAVI) which combines benefits of antegrade transapical approach and high safety profile characteristic of transfemoral approach. This method has substantial advantages over subclavian and transapical approaches in cases of pronounced myocardial hypertrophy, left ventricular dysfunction, thinning of left ventricular wall. We describe here a hybrid intervention with simultaneous coronary artery bypass grafting and TAVI in a patient from high surgical risk group with multivessel coronary artery involvement and critical aortic stenosis.
View Article and Find Full Text PDFAn abdominal aortic aneurysm appears to be combined with aneurysmatic lesions of the common iliac arteries in 30-40% of cases. Like abdominal aortic aneurysms, aneurysms of the common iliac arteries rarely manifest themselves clinically. The lethality rate in case of rupture is comparable to that for rupture of an abdominal aortic aneurysm.
View Article and Find Full Text PDFAnesteziol Reanimatol
July 2016
The Aim: to determine the efficacy and safety of dexmedetomidinefor sedation and analgesia during transcatheter aortic valve implantation (TA VI) withfemoral access.
Materials And Methods: the study included 34 high-risk surgical patients with "critical aortic stenosis". All patients underwent TAVI with femoral access.
Angiol Sosud Khir
October 2015
Spontaneous rupture of the aorta is an uncommonly encountered acute surgical aortic pathology characterised by an utterly unfavourable prognosis. The article deals with a case report concerning successful endovascular treatment of spontaneous rupture of the thoracic portion of the aorta, followed by discussion of problems regarding aetiology, diagnosis, and therapeutic policy for such pathology.
View Article and Find Full Text PDFSurgical aortic valve replacement is the standard therapy for severe aortic valve stenosis, however one third of patients are rejected because of high surgical risk. Under medical treatment alone these patients have a very poor prognosis with a high mortality rate. We present a case of 70-year-old male patient with degenerative symptomatic critical aortic stenosis and chronic lymphocytic leukemia.
View Article and Find Full Text PDFPurpose: To find an advisability of use of invasive monitoring of intracardiac haemodynamics during transfemoral transcatheter aortic valve replacement.
Patients And Methods: The study included 12 patients underwent transfemoral transcatheter aortic valve replacement (TTAVR). All patients were monitored according to Harvard standard.
In patients with a juxtarenal abdominal aortic aneurysm the unaltered segment is frequently insufficient to secure adequate proximal fixation of the stent graft or is entirely absent, thus making it problematic to exclude the aneurysm from the blood flow by means of classic endoprosthetic repair. For this reason, in order to preserve the blood flow through visceral and renal arteries fenestrated endoprostheses are used as alternative minimally invasive treatment policy. Described herein is the first in the Russian Federation clinical case of using a fenestrated endovascular graft for treatment of a juxtarenal aortic aneurysm.
View Article and Find Full Text PDFSurgical aortic valve replacement is the standard therapy for severe aortic valve stenosis, however one third of patients are rejected because of high surgical risk. Under medical treatment alone these patients have a very poor prognosis with a high mortality rate. We present a case of 70-year-old male patient with degenerative symptomatic critical aortic stenosis and chronic lymphocytic leukemia.
View Article and Find Full Text PDFTo illustrate the present-day possibilities in treatment of aortic dissection we describe herein a clinical case report concerning successful prosthetic repair of a gigantic aneurysm of the infrarenal portion of the aorta with the Gore Excluder using an endovascular surgical approach in a patient running high risk associated with difficult anatomy of the abdominal portion of the aorta, iliac arteries, and accompanying diseases (left lung cancer, CAD, critical stenosis of the RCA. This was followed by balloon angioplasty with stenting of the RCA with Lekton stents with a good angiographic result. EVAR has become an alternative to the conventional open surgery with lower risk of complications, shorter hospital stay, and decreased mortality rate, which was confirmed by the findings of international studies.
View Article and Find Full Text PDFSurgical treatment for aortic valve (AV) pathology is an urgent and important problem of modern medicine. The prevalence of valve disease is great and remains steadily high in the population. Due to a large number of patients who cannot undergo open AV surgery, alternative hybrid treatments are recently being actively improved.
View Article and Find Full Text PDFThe present article aims to describe a clinical case of hybrid surgical intervention consisting in complete prosthetic repair of the aortic arch in a high-risk male patient diagnosed with a gigantic saccular aneurysm of the aortic arch. The patient was subjected to a hybrid operation--an operation of endovascular prosthetic repair of the thoracic portion of the aorta with the Gore Tag stent graft in a combination with bypass grafting of the left common carotid and left subclavian arteries with the Gore bifurcated stent graft, autovenous aortocoronary bypass grafting of the CA without artificial circulation. The postoperative period was uneventful with the patient's favourable convalescence and rehabilitation occurring within the shortest terms possible.
View Article and Find Full Text PDF33 patients (25 men and 8 women, aged 18 to 69 years, mean age 47 +/- 12.3 years), underwent ascending aorta and aortic arch replacement. During arch replacement the authors used the following brain protection methods: profound hypothermic circulatory arrest--in 4 (12.
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