The treatment of pulmonary valve disease is one of the urgent problems of modern cardiology and cardiac surgery. In most cases, pulmonary valve abnormalities are congenital. Synthetic conduits (homografts) and bioprosphetic valves are currently used in the surgical treatment of patients with the diseases mentioned above. Pulmonary valve surgical prosthetics allows normalizing the circulatory dynamics and condition of the patient, however, time-dependent degradation results in conduit and valve dysfunction. The abnormal circulatory dynamics caused by valve and conduit dysfunction is linked to exercise intolerance, arrhythmia, right ventricular failure, and sudden death. Starting in childhood, affected patients undergo repeated openheart surgeries to restore valve function and potentially reduce morbidity and mortality. Percutaneous transcatheter treatment of the pulmonary valve stenosis with the Melody® valve (Medtronic Inc.) has been performed in a large number of patients worldwide. Despite minimal invasiveness, this procedure restores pulmonary valve function and reduces repeated open-heart interventions. Recent clinical trials have shown excellent and durable results in terms of both restoring valve function and decreasing right ventricular outflow tract obstruction. In this article, we want to reflect the relevance of the Melody transcatheter valve and present our first experience of its usage.
The article is devoted to a clinical case of management of a young woman with an aneurysm and two atrial septal defects after the development of acute myocardial infarction. It conveys aspects of differential diagnosis and long-term management.
The search for the optimal approach in the treatment of brachiocephalic arteriovenous fistulas is one of the current problems of neurosurgery and vascular surgery. It is important to note that the best prognosis requires timely diagnosis and the earliest possible dissection of the fistula. Also, the method of treatment should have the least negative consequences and a good clinical effect. Previously, surgeons used open surgical vessel ligation with great technical difficulties due to anatomical difficulties of access as well as bleeding. In recent decades, the endovascular approach to treatment has demonstrated advantages over open interventions. Despite the low traumaticity, there is a risk of complications such as untargeted vascular embolization, perioperative stroke, etc. In this article we demonstrate the experience of arterio-venous vertebral artery fistula dissection using an occluder.
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