[Threatened paradoxical embolism, massive occlusion of pulmonary artery: risk stratification, treatment policy]. / Ugrozhaiushchaia paradoksal'naia émboliia, massivnaia okkliuziia legochnoi arterii: stratifikatsiia riska, taktika lecheniia.

Described in the article is a clinical case report regarding a male patient presenting with pulmonary thromboembolism, with a floating thrombus in the common femoral vein, in the right atrium, prolapsing into the right ventricle and propagating through a patent foramen ovale to the left atrium, thus being a threat of paradoxical embolism. The echocardiography findings demonstrated the following: mean pressure in the pulmonary artery amounting to 56 mm Hg, dilatation of the right atrium and right ventricle. The patient was subjected to simultaneous thrombectomy from the common femoral artery, from the right, left atria and pulmonary artery in conditions of cardioplegia, as well as ligation of the superficial femoral artery. The postoperative period proved uneventful. The patient was discharged on postoperative day 15, with pressure in the pulmonary artery amounting to 38 mm Hg. Besides, analysed herein are the contemporary literature data, clinical guidelines, and opinions of experts concerning treatment policy in this complex pathology.

[Strategy of treatment of aortic stenosis complicated by total calcinosis]. / Taktika lecheniia pri aortal'nom stenoze, oslozhnennom total'nym kal'tsinozom.

The authors made an analysis of problems of strategy of surgical treatment of 132 patients with aortal stenosis complicated by calcinosis. Detailed indications to surgical treatment for stenosis of the aortal valve are given depending on the stage of the disease and complications. The nuances of the technique of performing the operation of prosthesis of the aortic valve are described.

[A 2-stage method for the surgical correction of calcified aortic stenosis in patients with an extreme degree of risk for an operation]. / Dvukhétapnyi metod khirurgicheskoi korrektsii kal'tsinirovannogo aortal'nogo stenoza u bol'nykh s krainei stepen'iu riska operatsii.

During the period of 1992-1998 the authors dealt with treatment of 32 patients with aortic stenosis under extreme risk of operation. All the patients were considered to be inoperable because of the severity of their state. At the first stage of operation the catheter balloon valvuloplasty (CBV) was performed for decompression of the left ventricle since it was the only possible variant at this stage of surgical treatment. Good results of CBV were obtained in 22 patients which led to the possibility to perform the prosthetizing of the aortic valve in 13 patients within two months at an average. There were no lethal outcomes. Long-term results followed-up during 6 years were estimated as satisfactory.