[Immediate and Long-term Results of the First in Russia of IntrocoronaryMetal Stent in the Coronary Artery].

The authors present immediate and long term results of the first in Russia implantation in coronary artery of Palmaz-Shatz metal stent. Indications for stenting were urgent after complicated dissection as a result of balloon dilation of discrete bifurcational stenosis of anterior interventricular artery (IVA). Immediate angiographic and clinical result was good.

[The donor's heart 22 years after the orthotopic transplantation].

The orthotopic heart transplantation is an acknowledge method for the treatment of cardiomyopathies of various etiology. Specific vasculopathy of the transplanted heart is considered to be a significant problem of the long-term postoperative period and serves the reason of low 10-years survival rates (not more then 50%). The issue unites the experience of follow-up and intravital electronic microscopy of transplantated heart's biopsies from 20 patients.

[Prevalence and influence of risk factors on coronary shunting operations in patients with aterosclerosis of abdominal aorta and peripheral vessels].

Retrospective study analysis concerning the prevalence of risk factors for unfavorable outcomes after coronary operations in patients with peripheral arterial atherosclerosis is presented. Meta-analysis of individual risk factors was carried out. Frequency of complications after coronary shunting in patients with various concomitant diseases is evaluated.

[Algorithm of cardiac risk assessment before vascular surgery].

to detect the informative value of algorithm of cardiac risk assessment recommended by American Heart Association compared with original standard enlarged protocol. Overall 456 patients underwent vascular operations. First group consisted of 198 patients who were examined according original enlarged protocol; other 258 patients (2nd group) were examined with AHA protocol.

[Combination of reconstructive vascular operations with gene-engineering technologies of angiogenesis stimulation: a present-day policy aimed at improving the remote results of treating patients with lower limb chronic ischaemia].

The authors have studied therapeutic outcomes in a total of 38 patients diagnosed with occlusions of the femoropopliteal segment. In the Study Group patients (n = 19), the operation of femoropopliteal bypass grafting was supplemented by using gene stimulators of angiogenesis (gene constructions with the genes of vascular endothelial growth factor, and angiogenin). The Control Group patients (n = 19) were subjected to a reconstructive vascular operation alone.

[Preservation of subvalvular mechanism at mitral valve replacement].

According to literature data there is no common approach to method of mitral valve replacement with preservation of subvalvular structures. Results of 175 operations of mitral valve replacement are analyzed. The preservation of fibrous-papillary contact must not be regarded as the goal itself, but it must improve the clinical effect of operation.

[Functional and anatomic classification in the surgery of combined thoracoabdominal aorta aneurysms].

The functional and anatomic classification of occlusive lesions of arterial system is proposed. This classification permits to evaluate the sate of arterial bed, the bulk and priority of affected arteries revascularization at patients with thoracoabdominal aorta aneurysms, to choice optimal treatment tactics, and to carry out the dynamic evaluation before and after surgery.

[Clinical, diagnostic and surgical aspects of heart space-occupying lesions at children and youths].

Clinical, diagnostic and surgical aspects of primary heart tumors, pseudotumor and morphologically unidentified heart space-occupying lesions were analyzed at 52 childhood and adolescence patients. Difficulty of early diagnosis, more aggressive clinical course in majority cases, and individual approach to the choice of surgical approach has been demonstrated. Principle of oncological determinant has been ensured the success in surgical treatment of patients with non-malignant intracavitary and intramuscular neoplasms, and also with pseudotumor space-occupying lesions.

[The technologies of genetic engineering in treatment of chronic lower limb ischemia].

The article contains experimental data on angiogenesis stimulated by plasmid containing the angiogenin gene. After the introduction of the gene construction, the number of capillars in the chorion-allantois membrane increases 2 to 3 times; in an ischemized limb of a rat it increases by 20 to 30%. Intramuscular administration of genetic engineering construction to patients with chronic lower limb ischemia improved the patients' condition, consisting in an increase in painless walking distance and ankle-brachial index, as well as in trophic defect healing and the betterment of muscular perfusion.

[Surgical treatment of dilated cardiomyopathy].

The efficacy and safety of different variants of left ventricular geometrical reconstruction (LVGR) in patients with dilated cardiomyopathy (DKMP) were studied in 2-stage clinical trial during 4 years. Results of left ventricle plication, "Myosplint" surgery and implantation of extracardial net framework (ECNF) complemented with mitral insufficiency correction (in case of need) have been evaluated on the first stage of the study. Based on this study, the implantation of ECNF and correction of mitral insufficiency are recognized as the most effective and safe method of DKMP surgical treatment.

[Preventive intraaortic balloon counterpulsation during surgical myocardial revascularization].

Fifty patients with low myocardial functional reserves (left ventricular ejection fraction less than 40%, disseminated cardiosclerosis, multiple affection of coronary arteries, NYHA class III-IV) after coronary artery bypass surgery (CABS) were examined. All the patients were divided into 2 groups. Preventive intraaortic balloon counterpulsation (IABC) was used in 24 patients (group 1).

Surgical management of patients with ascending aortic aneurysms.

Between 1988 and 2002, 104 patients with ascending aortic aneurysms were operated on. The patients were distributed into 2 groups: the first group presented with aortic incompetence (n=66) and the second one had no aortic incompetence (n=38). In the first group, 8 patients received valvesparing operations, 58 (88%) patients underwent replacement of the aortic valve and ascending aortic segment according to different techniques.

[The CELO-ANG recombinant avian adenovirus with human angiogenine gene inducing neovascularization in the anterior tibial muscle of rat].

The CELO recombinant avian adenovirus carrying the gene coding the human angiogenine (ANG) synthesis was obtained. Expression of the angiogenine gene was shown in the LMH cell culture after infection with the CELO-ANG virus. The ability of CELO recombinant adenoviruses to carry out the delivery and expression of alien genes in muscle cells was demonstrated in experiments with laboratory animals (Wistar line rats).

[Transplantation of the liver right lobe from a related donor].

From 1997 to 2003 transplantation of liver's right lobe from alive related donor was performed in 64 patients (28 men, 36 women) aged from 6 to 61 years (mean age was 22.6 +/- 3.2 years).

[Genetic engineering potential and perspectives in the management of critical ischemia].

The paper presents a new approach to management of lower limb critical ischemia which implements recent advances in molecular biology and genetic engineering technologies. A new original compound incorporating angiogenin gene was developed to activate neoangiogenesis processes after injection into living tissues. Experimental data evidence a potential efficacy of new method for complex management of critical ischemia.

[Transplantation of the right hepatic lobe from an alive relative donor].

The use of relative donors in the transplantation of the liver has shown a good performance as an alternative line in its orthotopical grafting. Shortage of donor organs actively stimulates the development of relative transplantation. The main problem of relative hepatic transplantation is the limited capacity of obtaining a required mass of a hepatic graft for obese recipients.

[Electrical stimulation of the spinal cord in cardiovascular disease].

The early and late outcomes of electrical stimulation of the spinal cord are analyzed in chronic critical ischemia of the lower extremities and coronary heart disease with peripheral involvement of coronary arteries. The clinical capacities of this treatment that has enjoyed little use in our country due to its high cost showed atraumaticity of electrical stimulation of the spinal cord; a few cases of complications and no hospital mortality; a rapid positive clinical effect after the initiation of electric neurostimulation, and better life quality in patients in the postoperative periods.

[B. V Petrovsky's scientific school at the turn of two centuries].

The paper shows how Academician B. V. Petrovsky's scientific school has been set up and how it has developed.

[Surgical correction of incomplete form of open atrioventricular canal in adults].

Clinical and anatomo-hemodynamic features of adult patients with incomplete form of the open atrioventricular canal are presented, policy of surgical treatment and optimal degree of surgical intervention on mitral valve are determined. The study of variant anatomy of the defect, revealed two variants of left atrioventricular valve formation (with "functional" and with "anatomical" septal commissure). In the first anatomic variant the mitral insufficiency was hemodynamically important and required surgical correction.

[liver portion transplantation from living donor: pilot clinical experience].

The unique in Russia experience of 35 liver transplantations since 1990 has revealed benefits of the method and quite encouraging results with 81% survival of the recipients. But the extreme shortage of cadaveric donor organs followed by more than 60 per cent mortality in waiting list and absence of any real facilities to improve the situation dictate the living related donation to become a considerable alternative. Totally 12 living related liver transplant procedures were performed with no morbidity in donors.

[Surgical treatment of carotid chemodectomas].

49 patients have been examined and 38 of them operated in RRCS RAMS for carotid hemadectomas (CH). CH is a rather rare tumor developing from the carotid gland locating in bifurcation of the common carotid artery. It is slowly growing tumor which is scantily active and rarely metastasizes.