сердечно-сосудистой хирургии Министерства здравоохранения РФ, гл. врачд. м. н. В. А. Сакович; 2 ГБОУ ВПО Красноярский государственный медицинский университет имени проф. В. Ф. Войно-Ясенецкого Министерства здравоохранения РФ, ректор-д. м. н., проф. И. П. Артюхов; кафедра клиника сердечно-сосудистой хирургии ИПО, зав.-д. м. н. В. А. Сакович; 3 КГБУЗ Красноярский краевой клинический онкологический диспансер имени А. А. Крыжановского, гл. врач-к. м. н. А. А. Модестов. p%'>,%. В данном клиническом примере представлена симультантная операция на двух жизненно важных системах организма (дыхательная и сердечно-сосудистая) с использованием искусственного кровообращения. Пациенту с выраженным аортальным стенозом и тяжелой сердечной недостаточностью, в сочетании со злокачественным новообразованием верхушки правого легкого одномоментно выполнена операция-резекция доли легкого и протезирование аортального клапана с удовлетворительными результатами при выписке. Определены показания к этой операции, этапность подхода, а также проанализированы непосредственные результаты проведенной операции. j+>7%";% 1+." : симультантные операции, аортальный стеноз, рак легкого.
Aim. To analyze the preoperative status, intraoperative tumor characteristics and further clinical manifestations in patients after surgery for a cardiac tumor.Material and methods. The study included 54 patients who were operated on for a heart tumor from 2014 to 2020. We assessed clinical performance, diagnostic investigations before and after (during hospitalization) surgery, tumor size and histological characteristics.Results. Among patients operated on for cardiac tumors, women predominated (74%). Among comorbidities, hypertension (79,3%), chronic kidney disease (48,3%), and obesity (25,9%) were most common. There were following clinical manifestations before surgery: shortness of breath — 47 (81%) patients, palpitations and heart rhythm disturbance — 26 (44,8%), chest pain — 25 (43,1%), chest discomfort — 28 (49,1%), edema — 6 patients (10,3%). The predominant tumor localization was the left atrial fossa ovalis area (50%). According to histological analysis, myxoma prevailed — 38 cases (86,4%). After surgery, atrial fibrillation prevalence decreased from 8 patients before surgery to 6 after surgery (p=0,034), while left atrial size decreased by 0,6 mm (95% confidence interval, 4,39-6,2 mm) (p<0,001).Conclusion. According to presented analysis over a 6-year period, cardiac neoplasms are more common in women (74,1%), while the mean age of patients is 59,7 years. Among comorbidities, hypertension prevails — 79,3%. Histological examination revealed a predominance of myxoma (86,4%). Predominant tumor location was the left atrial fossa ovalis area (50%). Surgical treatment of neoplasms was effective. So, prevalence of atrial fibrillation decreased by 25%, while left atrial size decreased by 0,6 mm. Postoperative complications and in-hospital deaths were not registered.
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