Prospect of Using Cell Product for the Therapy of Skin Defects in Diabetes Mellitus.

The effectiveness of autologous cell product in the therapy of skin burn wounds was studied in C57B1/6 male mice against the background of streptozotocin-induced diabetes mellitus. In animals with and without modeled diabetes mellitus, significant decrease in skin defect area was observed after single administration of the cell product (bone marrow multipotent mesenchymal stromal cells, fibroblasts or media conditioned by these cells).

Risk of development of neurological complications in prosthetic repair of the aortic ascending portion and arch.

The study comprised a total of 68 patients (presenting) with chronic dissection of the aortic ascending portion and arch, undergoing surgery and subjected to measuring at various stages of the operation the level of cerebral oxygenation (rSO2) of the right and left hemispheres by means of bilateral transcranial spectroscopy. The aim of the study was to examine the risk for the development of neurological complications in patients with chronic dissection of the aortic ascending portion and arch in various methods of cerebral protection during aortic prosthetic reconstruction. Group One consisted of thirty-one 40-to-61-year-old (mean age 51 years) patients who during circulatory arrest (CA) were as cerebral protection subjected to antegrade cerebral perfusion (ACP) on the background of moderate hypothermia (23-24°C).

[Efficacy and safety of temporary bypass grafting in carotid endarterectomy].

The authors analysed interrelationship between the use of temporary bypass grafting during operations of carotid endarterectomy and the frequency of the development of ischaemic complications (stroke and transitory ischaemic attacks in the early postoperative period). It was shown that in the group wherein a temporary bypass graft was established only by the criterion of decreasing retrograde pressure ischaemic complications were encountered in ten (4.4%) patients and in the group wherein temporary shunts were established by the criterion of a simultaneous decrease in cerebral oxygenation and retrograde pressure - in two (0.

[Peripheral perfusion in CAD patients with various-stage chronic heart failure undergoing coronary artery bypass grafting].

Using the orthostatic test, we examined peripheral perfusion by means of laser Doppler flowmetry (LDF) and transcutaneous oximetry in a total of 104 patients presenting with coronary artery disease and functional class II-IV chronic heart failure (CHF) prior to coronary artery bypass grafting (CABG) and in the remote terms thereafter. Volumetric velocity of the microcirculatory blood flow (MCB) of the lower limbs was measured by means of LDF in perfusion units; partial oxygen pressure (TcPO2, mmHg) was registered by means of transcutaneous oximetry. The patients with CAD were subdivided into two groups as follows: Group One comprised patients with FC II CHF and Group Two included those with FC III-IV CHF.

Outcomes of the Ross procedure in patients with an accompanying ascending aortic aneurysm.

Analysed in the article are the results of the Ross procedure in patients presenting with dilatation of the ascending portion of the aorta. A combination of aortic valve defects with dilatation of the ascending aorta of more than 45 mm supposes simultaneous prosthetic repair of the aortic valve and ascending aorta. The most common surgical procedure remains the Bentall-DeBono operation whose main disadvantage is associated with implantation of a mechanical prosthesis and the necessity of lifelong anticoagulant therapy.

[Ways to improve immediate and remote results of carotid endarterectomy].

The authors analysed the results of carotid endarterectomy in a total of 469 patients with the use of simultaneous assessment of the oxygen status and collateral blood flow of the brain in order to determine feasibility of placing a temporary bypass, carried out at the Centre of Vascular and Hybrid Surgery of the Novosibirsk Scientific Research Institute of Circulatory Pathology named after Academician E.N. Meshalkin in 2008-2012.

Therapy of Chronic Cardiosclerosis in WAG Rats Using Cultures of Cardiovascular Cells Enriched with Cardiac Stem Cell.

We developed a protocol for preparing cardiac cell culture from rat heart enriched with regional stem cells based on clonogenic properties and proliferation in culture in a medium with low serum content. Experiments on WAG rats with experimental ischemic myocardial damage showed that implantation of autologous regional stem cells into the left ventricle reduced the volume of cicatricial tissue, promoted angiogenesis in the damaged zone, and prevented the risk of heart failure development.

Oxygen provision of the brain at various stages of operation in patients with chronic pulmonary artery thromboembolism.

The authors studied cerebral oxygen supply by means of cerebral oximetry in patients presenting with chronic pulmonary artery thromboembolism (PATE) at various stages of operation. The study was aimed at assessing cerebral oxygen supply while carrying out surgical treatment in patients with chronic PATE on the background of various methods of perfusion. Thromboendarterectomy (TEA) from the pulmonary artery with the use of circulatory arrest and craniocerebral hypothermia is accompanied by more pronounced impairment of oxygen supply of the brain with a decrease in the cerebral oxygenation indices by more than 30% from the baseline values.

CardiaMed mechanical valve: mid-term results of a multicenter clinical trial.

Background: Prosthesis choice is a major concern in valvular surgery.

Methods: A multicenter clinical trial was performed to assess the efficacy and safety of the CardiaMed prosthetic heart valve. The study enrolled 420 patients who underwent mitral (209) or aortic (211) valve replacement from 2003 to 2004 at 7 institutions in Russia, and who were followed up from 2006 to 2011.

Characteristics of cardiac cell cultures derived from human myocardial explants.

Primary cell cultures derived from human myocardial explants were obtained and characterized. The explant cultures contained cardiac stem cells (c-kit(+); ≈ 4%), microvascular cells (endothelial cells and pericytes), fibroblasts, and myofibroblasts. It was demonstrated that culturing of cardiac cells in cardiospheres did not promote enrichment of the cell culture with stem cells.

Relationship of blood levels of inflammatory and destructive biomarkers in coronary atherosclerosis with long-term results of surgical revascularization.

The relationships between blood levels of inflammatory and destructive biomarkers (TNF-α, IL-1β, IL-6, IL-8, soluble CD40 ligand, high-sensitivity C-reactive protein, endothelial adhesion molecules, matrix metalloproteinase 3 and 9 and their tissue inhibitor type 1) were studied in men with coronary atherosclerosis before and 5 years after coronary artery bypass surgery. In men with unfavorable course of coronary atherosclerosis in the delayed period, the initial blood levels of C-reactive protein and TNF-α by 1.7 and 3.

Stimulation of angiogenesis in rat ischemic limb by intramuscular implantation of mononuclear fraction cells from autologous bone marrow.

We studied angiogenic effects of two variants of indirect revascularization (transplantation of mononuclear fraction cells from autologous bone marrow alone or in combination with laser tunneling) after modeled ischemia of the lower limbs in rats. Doppler sonography and immunofluorescence studies showed that intramuscular implantation of isolated fraction of autologous bone marrow mononuclear cells in combination with laser tunneling of the muscles is most effective and can be recommended as a method of angiogenesis stimulation in non-reconstructable distal vascular pathology of the extremities.

Structural and molecular reorganization of cardiomyocytes in transposition of the main vessels.

Studies of myocardial autopsy specimens from infants (0-12 months) with transposition of the main vessels showed the formation of a complex of compensatory adaptive, degenerative, and destructive changes, manifesting at a tissue level in cardiomyocyte heterogeneity and formation of cardiosclerosis zones. Cardiac myosin synthesis was replaced by synthesis of skeletal myosin, which was detected at the molecular level. Clinically it manifested in the progress of heart failure.

Morphological and molecular analysis of angiogenesis after intramyocardial transplantation of autologous bone marrow mononuclear cells.

We studied the peculiarities of angiogenesis in the postinfarction period after transmyocardial laser revascularization and intramyocardial implantation of mononuclear bone marrow cells into the pericicatrical zone of the left ventricular myocardium in dogs. Morphological manifestation of angiogenesis in the myocardium after application of laser and cell technologies are angiomatosis, formation of large thin-wall vessels and sinusoids. The angiogenic effect of implanted mononuclear bone marrow cells is determined by high content (43-47%) of CD31+ cells in both adherent and nonadherent fractions.

Blood levels of inflammatory and destructive biomarkers in coronary atherosclerosis of different severity.

In male patients with coronary atherosclerosis without acute coronary syndrome, the levels of inflammatory-destructive biomarkers of atherosclerotic plaque instability depended on the severity and dissemination of coronary atherosclerosis. The highest levels of C-reactive protein and matrix metalloproteinase 3 were found in men with atherosclerotic involvement of all three main coronary arteries, primarily their middle and distal segments, and in men with predominance of low-grade stenoses (<50%) of coronary arteries in areas of atherosclerotic plaques.

Cardiomyocyte regeneration in pericicatricial zone of the myocardium after laser tunneling and implantation of bone marrow mononuclear cells.

Using canine model of chronic postinfarction myocardial ischemia we evaluated angiogenesis and cardiomyogenesis after combined revascularization by laser tunneling of the pericicatricial zone followed by implantation of bone marrow mononuclear cells into the channels. It was shown that the numerical density of arterioles and capillaries considerably increased 1 month after revascularization. We also observed a considerable increase in the density of cardiomyocyte nuclei in the test area, a 2-fold increase in the total area of nuclei, and an increase in the mean area of cardiomyocyte nuclei.

Morphological evaluation of cytoarchitectonics of aortic graft at the biotechnological stage with analysis of changes in laser-induced fluorescence spectra.

We performed a fluorescent microscopic examination of human and animal aortic grafts at different stages of decellularization. Treatment of aortic grafts with trypsin/EDTA solution for 48 h leads to their complete decellularization and preserved the connective tissue fiber backbone, which gains a netlike structure. The use of this protocol of decellularization leads to disappearance of subintimal calcium deposits in human aortic grafts.

[Endovascular treatment of major vascular aneurysms: successful experience].

Major vascular aneurysm is a severe pathology with poor prognosis. Due to wide variations of vascular anatomy, an endovascular intervention may require intraoperative adjustment of procedural strategy. The paper presents results of successive stent-graft implantations in different anatomical situations.

Role of chemical elements in formation of an aortic aneurysm.

The method of X-ray fluorescence employing synchronous radiation was used to study the content of chemical elements (CE) in the aortic wall in patients suffering from CAD (Group I), patients diagnosed with an ascending aortic aneurysm (Group II), and those presenting with aortic dissection (Group III). The obtained findings revealed a pronounced CE disbalance in the aortic wall in Group II and III patients as compared with Group I patients, suggesting an important role of trace and macroelements in metabolic processes related to formation of artic aneurysms. Based on the degree of the ascending aorta dilatation, we determined the coefficient of the ratio of the ascending aorta maximal diameter to the fibrous ring aortic valve diameter, equalling 1.

The choice of the technique for harvesting and preparation of the radial artery for coronary artery bypass grafting.

At present coronary artery disease (CAD) is a most frequently occurring cause of the lethality and disability of patients. One of the basic methods for CAD treatment is coronary artery bypass grafting (CABG). Actuality of the problem of applying the radial artery (RA) for CABG is determined by the proven advantage of arterial grafts versus vein grafts in myocardial revascularization.

Successful surgical treatment by extraanatomic bypass grafting of a pseudoaneurysm of anastomosis after aortic replacement for coarctation complicated by septic aortitis.

Presented herein are the results of successful surgical treatment by extraanatomic bypass grafting of coarctation of the aorta complicated by septic aortitis and a pseudoaneurysm of the anastomosis between the graft and aortic arch.

[Endovascular treatment of subclavian arterial aneurysm using stent graft].

The authors describe a clinical case of successful endovascular treatment of subclavian arterial pseudoaneurysm using the stent graft JOSTENT-GRAFT 48 mm in length and 6 mm in diameter in a 49-year-old patient. The aneurysm developed over a length of 2 years as a result of polytrauma without remarkable circulatory disorders in the distal arterial bed of the upper extremity. Further existence of aneurysm was conjugated with a risk of ischemic or neurologic complications.

Effect of calcium antagonists on ultrastructure of myocardial microvessels during open heart surgery under conditions of pharmacological and cold cardioplegia.

Ultrastructure of myocardial microvessels was examined during surgical correction of congenital heart disease (ventricular septal defect) under conditions of cold and pharmacological low-potassium cardioplegia without perfusion. Addition of calcium antagonist verapamil to cardioplegic solution prevented postischemic damage to vascular and perivascular structures occurring during reperfusion and body temperature rise.

Effectiveness of forced air warming after pediatric cardiac surgery employing hypothermic circulatory arrest without cardiopulmonary bypass.

Study Objective: To evaluate the effectiveness of forced-air warming compared to radiant warming in pediatric cardiac surgical patients recovering from moderate hypothermia after perfusionless deep hypothermic circulatory arrest.

Design: Prospective unblinded study. SETIING: Teaching hospitals.