[Catheter-directed thrombolysis in iliofemoral thrombosis and aplasia of the inferior vena cava]. / Kateter-napravlennyi trombolizis pri iliofemoral'nom tromboze i aplazii nizhnei poloi veny.

Demonstrated in the article are the results of catheter-directed thrombolysis in a male patient presenting with bilateral acute iliofemoral venous thrombosis on the background of aplasia of the inferior vena cava. The incidence rate of this pathology is specified, with an emphasis on no recommendations on choosing optimal therapeutic strategy in this cohort of patients. The main causes and complications of the disease are described. The realized policy of revascularization demonstrated its safety and efficacy. The chosen method of correction resulted in a successful outcome of treatment, preventing phlegmasia cerulea dolens. This policy can be recommended as most preferred for patients with acute iliofemoral venous thrombosis on the background of aplasia of the inferior venal cava.

[Thrombosis of the inferior vena cava and right portions of the heart in a relapsing retroperitoneal malignant tumour]. / Tromboz nizhnei poloi veny i pravykh otdelov serdtsa pri retsidivnoi zabriushinnoi zlokachestvennoi opukholi.

Presented herein is a clinical case report regarding successful treatment of a female patient with a relapsing malignant retroperitoneal tumour complicated by disseminated thrombosis of the inferior vena cava, right atrium and right ventricle of the heart. A relapse of the malignant uterine tumour had developed 3 years after the primary operation and was represented by a large-size mass ingrowing into the infrarenal segment of the inferior vena cava, aorta, as well as jejunum. Additional examination revealed the presence of a tumorous thrombus extending from the primary tumorous node in the lumen of the inferior vena cava to the right atrium and ventricle. The procedures performed consisted in removal of the tumour with resection of the inferior vena cava, aorta, and jejunum, followed by thrombectomy from the right portions of the heart under extracorporeal circulation. The postoperative period turned out uneventful, with no complications observed. The woman was discharged on POD 15. Twelve-month postoperative follow up revealed neither relapse nor progression of the disease. Currently, the patient continues undergoing specific treatment (second-line chemotherapy). Also discussed in the article are current challenges concerning both the classification of tumour thrombosis of the inferior vena cava in retroperitoneal sarcomas, and the choice of optimal strategy and policy of treatment.

[Primary aorto-intestinal fistulas (review of the literature and description of clinical case reports)].

The article contains a review of the literature dedicated to a rare complication of an abdominal aortic aneurysm, i.e., an aortic-intestinal fistula, and a report of two clinical cases illustrating different tactical approaches to management of this pathology in the settings of a referral department.

[Hybrid operating room: a new horizon in cardiovascular surgery].

Creating hybrid operating rooms (OR) is a new stage of the development of present-day cardiovascular surgery, with the need for these operating suites having evolved resulting from rapid implementation of novel techniques of treating cardiovascular diseases, combining elements of «open¼ and endovascular surgery. Despite widespread interest in this problem, there are virtually no systematized works properly describing the specificity of designing and organization of the hybrid OR's work. The present work was aimed at compiling the literature data and sharing own experience gained in organization of the hybrid OR, designation of indispensable technical and organizational requirements for performing hybrid interventions, studying the basic problems related to designing and building such operating rooms, as well as organization and management of the personnel.

[Prognosis of clinical outcomes in patients with critical ischemia of the lower extremities].

The authors propose a system of assessment of the state of blood circulation in lower extremities which allows planning a more effective method of treatment of patients with obliterating diseases in the stage of critical ischemia.

The use of perftoran in the treatment of patients with critical lower limb ischemia.

The aim of the study was to examine the potential of perftoran for the treatment of patients with critical lower limb ischemia, in whom surgical revascularization appeared not feasible in view of the type of lesion or severity of concomitant pathology. The study accrued 85 patients distributed into the basic and control groups. The control group patients (n=40) received the basic conservative therapy including rheological, vasoactive drugs, anticoagulants and aggregation inhibitors. Patients entering the basic group (n=45) were administered perftoran infusions together with the basic therapy protocol. We examined the time course of changes in the painful syndrome, ascertained the degree of ischemia, the extent of trophic disorders, the parameters of the peripheral flow in the pedal arteries by ultrasound Doppler (USD), and the intensity of the manifestations of the systemic inflammatory response. It has been proven that the use of perftoran is justified and that the preparation may be recommended for use in multimodality treatment of the patient group under consideration.

[The use of the synthetic material Vitaflon in cardiac surgery on the growing organism]. / Primenenie sinteticheskogo materiala "Vitaflon" v kardiokhirurgii rastushchego organizma.

Clinico-experimental investigations of Vitaflon in cardiosurgery of growing organism have shown that Vitaflon is a firm, plastic and good material for patches of different size and form, has high thrombus resistance. Inflammatory alterations in the surrounding tissues were not pronounced. The ingrowth of the connective tissue elements into the pores of the patch and its endothelialization were noted. Since 1996 the material has been used as patches in surgical correction of congenital heart diseases. The follow-up of the patients during 4 years failed to find symptoms of recanalization, thrombotic and infectious complications. Vitaflon can be widely used as a plastic material in cardiosurgery for congenital heart diseases.