[Efficiency of Operation Trombendarterektomy From Pulmonary Artery Branches Depending on the Degree of Pulmonary Hypertension and Duration of Disease].

AIM: to assess effect of thromboendarterectomy from pulmonary artery branches on clinical functional state of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in dependence on degree of pulmonary hypertension and disease duration. MATERIAL: Patients (n=152) were divided into 3 groups: (1) with systolic pulmonary artery pressure (SPAP) less or equal 50 mm Hg (n=20), (2) with SPAP>50- less or equal 80mm Hg (n=46), (3) with SPAP >80mm Hg (n=86). METHODS: Examination included registration of dynamics of general clinical state and character of complaints, six-minute walk test, transthoracic echocardiography with measurement of SPAP and right ventricular ejection fraction, pulmonary perfusion scintigraphy with calculation of index of perfusion deficit. RESULTS AND CONCLUSION: Pulmonary thromboendarterectomy from pulmonary artery branches was associated with stable improvement of clinical functional state of patients with CTEPH and regression of symptoms irrespective of preoperative level of pulmonary hypertension.

[Five-year results of surgical management of patients with chronic post-embolic pulmonary hypertension].

Over the period from 2004 to 2013, a total of 146 patients presenting with chronic post-embolic pulmonary hypertension (CPEPH) underwent the operation of pulmonary thromboendarterectomy (TEE) at the Centre for Surgery of the Aorta, Coronary and Peripheral Arteries. The operation was carried out according to the conventional technique with the use of hypothermia and circulatory arrest. The dynamics of the clinical and functional state was assessed by analysing the following parameters: 6-minute walk test, mean pulmonary artery pressure, and resistance of lesser circulation vessels (according to the data of catheterization of the right parts of the heart), as well as the diameter of the pulmonary artery trunk (by data of MSCT angiography of the pulmonary artery). The distance of the 6-minute walk was indicative of the corresponding functional class of chronic heart failure according to the NYHA classification. The obtained results showed that pulmonary TEE eliminates the main cause of pulmonary hypertension - thrombotic obstruction of pulmonary arteries, thus leading to normalization of the lesser circulation, a decrease in the load on the right ventricle and, consequently, to considerable improvement of the functional state of patients. Performing the operation of TEE from PA branches leads to improved clinical and functional condition of patients with CPEPH both at the hospital stage and further in the remote period after surgery, which is confirmed by a more than 2.5-fold increase of the 6-minute walk distance and a decrease of CHF functional class (by NYHA). A decrease of vascular resistance of the lesser circulation from 539.66±120.59 din×s×cm(-5) before surgery to 101.39±89.20 din×s×cm(-5) in the remote period is indicative of remodelling of the right ventricle and distal arterioles of the lesser circulation. A decrease of the PA trunk diameter from 35.10±5.25 mm before the operation to 30.30±8.65 mm in the remote period is suggestive of structural rearrangement of the pulmonary arterial bed with a tendency towards normalization and of efficacy of surgical treatment performed.

[Polymorphism of microsatellite DNA and study of maize genetic resources].

Microsatellite loci PCR-analysis of 80 maize lines and hybrids from two regions of Ukraine has been carried out. Allelic sets individual for each maize genotype have been revealed and discrimination potential of applied marker system has been determined. Comparative analysis of frequencies of alleles and genotypes occurrence in both samples has been carried out and possible participation of the investigated SSR-loci in formation of maize adaptability system has been shown.