[Assessment of remote survival in patients with peripheral atherosclerosis after endured interventions on coronary arteries].

The article deals with a retrospective analysis of the risk for the development of unfavourable outcomes in vascular patients after interventions on coronary arteries versus those without them. The authors assessed remote survival in patients with atherosclerotic lesions of the coronary and vascular beds as compared with isolated coronary artery bypass grafting. All patients were at the Federal Centre for Cardiovascular Surgery from October 2008 to December 2009 and later on underwent planned examination at a polyclinic. The patients were subdivided into the following groups: Group 1 comprised a total of 131 vascular patients undergoing single-stage or stepwise operations on coronary arteries (CA) (CABG + peripheral vascular disease). They were also subjected to interventions on the abdominal aorta, carotid arteries and lower-limb arteries. Group 2 (PVD) comprised a total of 153 vascular patients without myocardial revascularization with documented indications for coronary artery bypass grafting according to the findings of coronography and noninvasive methods of examination. Group 3 (CABG) consisted of 258 patients without symptoms of peripheral atherosclerosis who underwent CABG and were examined at a polyclinic over the same period of time as the study groups. The findings of examination confirmed the world-literature discussed proposition suggesting that preventive CABG considerably improves the long-term prognosis for vascular patients. This is of special importance taking into consideration that a preventive intervention on CA brings no additional risk of operative treatment.

[Simultaneous operations on the carotid and coronary arteries - the risk is due to?].

The article deals with the findings of a retrospective study regarding the incidence of risk factors for unfavourable outcomes during interventions on coronary arteries in patients presenting with atherosclerotic lesions of the carotid basin as compared to aortocoronary bypass grafting alone, followed by analysing individual risk factors. Also evaluated herein is the incidence rate of complications after coronary bypass grafting in patients presenting with various concomitant pathology, followed by determining the relative risk influencing hospital mortality both by groups as a whole and with due regard for stratification along the most significant risk factors. The study comprised a total of 74 patients with combined atherosclerotic lesions of carotid and coronary arteries, who were simultaneously subjected to revascularization of the myocardium and carotid basin. The control group was composed of 1,128 patients undergoing coronary bypass grafting alone. All patients were treated at the Federal Centre for Cardiovascular Surgery under the Russian Federation Ministry of Public Health and Social Development (Penza) from October 2008 to December 2011. The obtained findings confirmed the proposition that a simultaneous intervention of the CA does not increase the postoperative complications rate. The method of stratification demonstrated that the risk for the development of lethal outcomes in such patients turned out considerably higher. Patients with CA stenosis run higher risks of operational vascular complications, which is confirmed by a comparable level of mortality, cerebral strokes and myocardial infarction with the stratified group of patients having similar incidence of risk factors. Preventive interventions on the CA are aimed at decreasing operative complications and bring no additional risk to the lethality rate.

[Quality of life and late outcome of radical correction of Fallot's tetrade after reconstruction of outflow tracts from the right ventricle without plastic surgery on the interventricular septum defect].

Results of radical correction of the Fallot tetrade after reconstruction of outflow tracts from the right ventricle (RV) without plastic surgery on the interventricular septum defect were evaluated in 25 patients aged 5-30 (mean 12.3 +/- 3.8) years in the late postoperative period (1-10, mean 6.5 years). Clinical condition of the patients on the moment of examination was satisfactory, they had no complaints. 14 (56%) patients needed second operation within 2.9 +/- 1.9 (mean) years after primary surgery. It significantly increased the number of patients referred to 1-2 functional classes NYHA (from 56 to 60% and from 28 to 32% respectively). The number of patients of functional class 3 decreased from 12 to 8%). The were no FC-4 patients. Survival rate estimated by the actuarial method was 92% by year 9 postoperatively. 84, 76, 72, 60, and 56% of the patients did not need second operation 1, 2-3, 4, 7, and 9 years respectively after primary surgery due to adequate care in the early postoperative period, timely diagnosis of complications, and their rapid management. It is concluded that radical correction of Fallot's tetrade after reconstruction of outflow tracts has good or satisfactory outcome in 92% of the patients.

[Causes of second operations after surgical treatment of congenital tricuspid valve abnormalities].

Main causes necessitating replacement of tricuspid valve (TV) prosthesis were calcinosis and infectious endocarditis of the bioprosthesis. Second operations after primary reconstructive surgery for the replacement of TV prosthesis were needed when medical indications did not fully justify the use of valve salving surgery by the Danielson's method and in case of procedural errors during surgery by the method of Carpentier in the initial period of mastering these approaches.