[Effect of renal artery stenting on the clinical and geriatric status of elderly patients with vasorenal hypertension.]

The study consists in determining the effect of renal artery stenting in patients with arterial hypertension in combination with renal artery stenosis on the dynamics of clinical and geriatric status in terms of such indicators as the number of drugs taken, cognitive status, determined by the MMSE scale, prevalence of the frequency of falls, psycho-emotional status by the Beck scale, the quality of sleep on the VAS scale, the index of age discrimination according to the E.Palmore ageism questionnaire, the quality of life according to the SF 36 questionnaire. The study involved 72 elderly patients with arterial hypertension in combination with renal artery stenosis. According to the results of the study, as a result of stenting of the renal arteries, there is a decrease in the number of drugs taken, an improvement in the cognitive status on the MMSE scale, a decrease in the frequency of falls, an improvement in the psycho-emotional status on the Beck scale, an improvement in the quality of sleep on the VAS scale, a decrease in the level of age discrimination, an increase in the quality of life according to questionnaire SF-36 on all scales.

[Transcheter aortic valve implantation as a method of treatment of chronic heart failure in elderly and old patients: Literature review (part 2).]

The most common heart valve defect among the elderly and senile is aortic valve stenosis. The traditional method of treating severe aortic valve stenosis is open surgery to replace aortic valve. At the same time, a more modern, minimally invasive method of correcting aortic stenosis is transcatheter aortic valve implantation (TAVI). This intervention is primarily indicated for patients of old age suffering from severe chronic heart failure associated with aortic stenosis, who have a high surgical risk. Currently, TAVI has evolved from a complex and dangerous procedure into an effective and safe method of treatment thanks to the development of a new generation of devices. Currently, there are still topical issues of using TAVI in individual clinical cases (use of TAVI in the elderly (60-75 years), TAVI in centenarians (90 years or more), TAVI in frailty, the feasibility of performing TAVI with low surgical risk, etc.), as well as issues related to longevity valves used for TAVI and prognosis in terms of quality and life expectancy.

[Transcheter aortic valve implantation as a method of treatment of chronic heart failure in elderly and old patients: Literature review (part 1).]

Aortic valve (AV) stenosis is the most common acquired valvular disease with an increasing prevalence due to an aging population, requiring surgical or endovascular intervention. Transcatheter Aortic Valve Implantation (TAVI) represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk patients with severe symptomatic AV stenosis. TAVI allows for the correction of aortic defect in the most severe group of patients with chronic heart failure (CHF) with severe comorbidity, who are contraindicated for open surgery to replace AV, in order to interrupt the vicious circle in the progression of CHF, stimulate reverse myocardial remodeling, alleviate symptoms, improve the quality of life, and prognosis of patients, and also as a «bridge¼ to heart transplantation. With the development of next-generation devices, TAVI has evolved from a complex and dangerous procedure to an effective and safe technique. Currently, the greatest scientific interest is the study of valve durability and the possibility of expanding the indications for performing TAVI in categories of patients with low surgical risk, as well as in younger age groups.

[Modern look at endovascular treatment bleeding the gastrointestinal tract in elderly patients.]

A literature review of the publications of foreign authors on the treatment of non-varicose bleeding from the upper gastrointestinal tract of elderly and senile patients is presented. The authors showed a modern view of the possibilities of endovascular hemostasis in comparison with a surgical operation with inefficiency of endoscopic hemostasis and characterized patients in whom it is possible this will be most effective.

[HYBRID REVASCULIZATION AS METHOD OF SURGICAL TREATMENT OF ISCHEMIC CORONARY DISEASE IN NUMEROUS LESIONS OF CORONARY BED].

Hybrid revasculization of myocardium combined the advantages of mammary-coronary bypass surgery and coronary arteries stenting. It presented itself as a perspective direction in treatment of ischemic coronary disease. The article provides the results of comparison of usage of hybrid revasculization of myocardium and aortocoronary bypass in 71 patients with multivessel coronary artery disease. The data obtained indicated, that hybrid approach allowed complete revasculization of the myocardium (as in case of aortocoronary bypass), fast recovery of the patient, shortening a hospital stay due to decrease of intra- and postoperative complications.

[DIRECT REVASCULIZATION OF THE MYOCARDIUM FROM LEFT-SIDE MINITHORACOTOMY - MODERN PERFORMANCE OF THE OPERATION NAMED AFTER V.I. KOLESOV].

The article provides the results of minimally invasive direct revasculization of myocardium at the period from 2012 to 2014. Given method was used in 49 interventions. There weren't any lethal cases or myocardial infarctions. A mean hospital stay consisted of 8,6±2,7. Computer thomographic coronary bypass angiography was carried out after operation in terms of 6-48 months. The occlusion of mammary coronary shunt was revealed in 3 patients with minimally invasive revasculization of the myocardium in terms up to 48 months. There were noted a decrease' of hospital stay, bleeding during surgery and in early postoperative period, duration of artificial pulmonary ventilation, length of stay in intensive care unit for this group of patients.

[Treatment of elderly patients with combination of coronary artery disease and aortic valve pathology].

Increasingly, there are patients with concomitant coronary artery disease and aortic valve, especially in elderly patients, who often have severe comorbidities and high surgical risk, which is undoubtedly a certain effect on the choice of method and tactics of treatment. Today, there are several approaches to the treatment of patients in this category, and all of them have certain advantages and disadvantages.

[Endovascular treatment of bifurcation lesions of the coronary arteries in elderly patients: a literature review N-2].

Intervention in bifurcation coronary arteries disease is complicated kind of endovascular treatment of coronary heart disease, especially in patients of elderly and senile age. Recently, in the practice of the operating surgeon there is a large choice of bifurcation coronary artery stents. This report contains the views, features and shortcomings of the presented bifurcation structures. Despite the fact that in the Russian Federation bifurcation stents are rarely implanted, their use can greatly simplify and accelerate interventional procedures, along with the decrease of peri- and postoperative complications.

[Endovascular treatment of bifurcation lesions of the coronary arteries in patients of elderly age: a review of the literature No 1].

Stenting of coronary artery bifurcation lesions is one of the most difficult types of interventional procedures for coronary heart disease. The frequency of coronary artery bifurcation lesion occurs up to 20%. The article reflects a wide variety of types of classifications of coronary bifurcations compared with the basic classification for A. Medina. Having considered the arts of bifurcations stenting, from a provisional Tstenting to complex procedures culote and crush stenting, we advocate the use of bifurcation structures, especially in elderly and senile.

[Hybrid methods in the treatment of heart disease in elderly and senile patients].

Hybrid technologies are becoming increasingly strong position in modern cardiac surgery. New standards and expanding the indications for use of these techniques are delivered. The advantages of hybrid interventions are to a substantial reduction in trauma patients during surgery, reducing the risk of both intra- and postoperative complications, death, the most important for the elderly and senile age.

[Features of antiagregant and anticoagulant therapy at a hybrid revascularization of a myocardium in elderly and senile patients].

The hybrid revascularization of a myocardium combines advantages of mammaro-coronary shunting and stenting of coronary arteries and represents the perspective direction in coronary heart disease treatment. This technique is of most value in patients of advanced and senile age, and also in patients of high surgical risk as it shows small injury, which enables to reduce and facilitate the postoperative period. However today, there is no single standard for the execution of these operations, in particular it is not clear, which scheme of antiagregant and anticoagulant therapy is worth adhering for greater efficiency of the procedures and patient safety.

[Implantation of stent- graft because of aorta rupture in polytrauma].

The article describes the clinical case and analyzes the literature concerning endoprosthesis replacement in the case of traumatic thoracic aortic injury in polytrauma. Current strategy of diagnostics and treatment of patient in critical condition with rupture of isthmic aortic part is based on the principle of multistage surgical treatment (damage control orthopedic). The external fixation of multiple pelvis and extremities fractures and on-time implantation of stent-graft in thoracic aortic part were performed at first hours after the admission. A condition of the patient was stabilized. The delayed reconstructive operations on pelvis and extremities bones allowed obtaining the satisfactory functional result. The principles of staged surgical treatment and the use of on-time high-technology methods allowed saving life for the patient even in critical situation in I level traumatologic centre.