ABSTRACT
An experience with using autologous bone marrow mononuclears for regeneration of the heart was analyzed in 97 patients in whom the intracoronary transplantation of autologous mononuclear bone marrow cells was performed. The results were estimated in terms up to 5 years and compared with a group of 37 patients who underwent only conservative treatment. A distinct positive dynamic of clinical and echocardiographic indices in the main group was noted in a subgroup of patients with a decreased ejection fraction (EF less than 50%) as compared with an analogous subgroup of patients in the control group. Substantial influence is exerted by regeneration therapy upon remote lethality. Thus, as a whole in the main group lethality over 5 years was 13.4% and in the group of control it was 21.6%. In the subgroup with a decreased ejection fraction and symptoms of heart failure lethality was 22.6% in the main group and 54.5%--in the control group. The intracoronary administration of the autologous bone marrow mononuclear fraction to inoperable patients with ischemic heart disease and a severe lesion of the coronary arteries and a decreased ejection fraction of the left ventricle is a safe and useful procedure resulting to substantially decreased lethality followed-up during 5 years against the background of conservative treatment.
Subject(s)
Bone Marrow Transplantation/methods , Myocardial Ischemia/surgery , Adult , Aged , Coronary Angiography , Echocardiography , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Ischemia/diagnostic imaging , Pilot Projects , Retrospective Studies , Time Factors , Tomography, X-Ray Computed , Transplantation, Autologous , Treatment OutcomeABSTRACT
The main group included 17 patients with distal lesion of the coronary bed in whom the performance of complete direct myocardium revascularization was not possible. The autologous bone marrow mononuclears were administered to the main group patients at the period from 2008 to 2010. The control group consisted of 10 patients given standard medicamentous therapy. A year later in the main group patients there was a decrease of median of the functional stenocardia class, median of metabolic units by the data of loading tests, median of the number of nitroglycerin pills for a week taken by the patients as compared with the control group. By the data of OECT and PECT a year later in the main group there was an improved perfusion in all the myocardium segments. In the control group on the contrary there was negative dynamics in all the indices in question.
Subject(s)
Coronary Artery Disease/surgery , Stem Cell Transplantation/methods , Aged , Female , Humans , Male , Middle Aged , Myocardial Revascularization/methods , Quality of Life , Treatment OutcomeABSTRACT
The authors made a comparative assessment of carotid endarterectomy and endovascular angioplasty with stenting in patients with atherosclerotic lesions of the carotid arteries. The authors consider that indications to stenting and carotid endarterectomy are identical in patients with stenose and occlusions of the carotid arteries. Contraindications to angioplasty of carotid arteries are determined. It was shown that angioplasty and stenting in atherosclerotic lesions of the carotid arteries was an effective method with a less number of complications as compared with carotid endarterectomy and are thought to be an adequate alternative to open surgical method of treatment of patients with stenoses and occlusions of the carotid arteries.
Subject(s)
Angioplasty , Carotid Arteries/surgery , Carotid Stenosis/surgery , Endarterectomy, Carotid/methods , Postoperative Complications/prevention & control , Stents , Aged , Angiography , Angioplasty/adverse effects , Angioplasty/methods , Brain/blood supply , Carotid Arteries/pathology , Carotid Arteries/physiopathology , Carotid Stenosis/diagnosis , Carotid Stenosis/physiopathology , Contraindications , Female , Humans , Male , Middle Aged , Patient Selection , Severity of Illness Index , Treatment OutcomeABSTRACT
An analysis of 490 operations in 442 patients with different variants of supraventricular and ventricular tachycardia was made. Complications developed in 23 cases (4.7%). The least (0.8%) risk of complications was noted in patients after destruction of the atrioventricular junction, the greatest (9.6%) in patients with abnormal junctions. Measures of treatment depended on the degree and severity of the complication and the character of concomitant disease. The division of complications into biogenic and technogenic allows the possible factors influencing their development to be differentiated. The frequency of complications is determined by complexity of the methods used and the necessary experience on the one hand, and by the severity of the patient's state and coexistent diseases on the other hand.
