Purpose. Description and illustration of the most common alternative causes of shortness of breath, cough, and acute chest pain in pandemic COVID-19 conditions. Material and methods. Authors evaluated results of the retrospective single-center study and instrumental data of 67 patients with complaints of sudden chest pain, cough and shortness of breath. For patients admitted to the hospital between March, 27 and June, 30, 2020, the first stage of diagnosis was made with the performed multispiral computed tomography (MSCT) of the chest, confirming the presence of pulmonary manifestations of COVID-19. The study did not include patients with pneumothorax identified at the pre - and hospital stages. We describe early radiographic changes in the chest organs, main vessels, and coronary bed in patients with CT-confirmed COVID-19 admitted to O.M. Filatov Municipal Clinical Hospital No. 15, Moscow for sudden chest pain, cough, and shortness of breath. Results. In CT of the chest organs, combinations of COVID-19 and pulmonary artery thromboembolism, central/peripheral lung cancer, and acute aortic syndrome manifestations were most common. Combinations of radiation techniques in pandemic settings are COVID-19 required by patients with the acute coronary syndrome. However, it will be possible to analyze all cases of a combination of acute chest pain and sudden shortness of breath in patients with COVID-19 only after processing an extensive array of data. Conclusion. In pandemic conditions, COVID-19 performing standard imaging methods should be not lost about the most frequent causes of chest pain and sudden shortness of breath, complementing native MSCT with contrasting enhancement in suspected pathology of the main arteries, and small circulation in high-risk patients.

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Analysis of the results of daptomycin antibiotic therapy and surgical treatment of 37 patients with infective endocarditis (IE) admitted to three Moscow hospitals during 2012 to 2016 is presented. Primary endocarditis was diagnosed in 32.4% of the cases. The secondary forms of the disease dominated by endocarditis following cardiac surgery (29.7%) including valve prosthetics and implantation of pacemaker/cardioverter-defibrillator (PM/CVD). Positive reaction in 2 or more blood cultures was observed in 73% of the patients with the prevalence of Staphylococcus aureus (27%). Vegetation at TT and emergency echocardiography was documented in 89.2% of the patients, fibrous ring or leaflet abscesses in 24.3%). All patients were treated with daptomycin at an average dose of 6,7 ± 0,7 mg/kg b w. The duration of therapy was 26,7 ± 9,8 days. Surgical treatment was given to 48.6% of the patients including PM/CVD replacement in 5.4%. Surgical mortality was absent. Hospital mortality amounted to 13.5%. The use of daptomycin in combination with surgical treatment can significantly improve the results of treatment of this serious disease.

В обзоре литературы представлена информация о различных вариантах хирургического лечения острого расслоения аорты типа А. Несмотря на увеличение количества клапаносохраняющих операций, одним из наиболее надежных и безопасных способов остается супракоронарное протезирование аорты, а также замена корня аорты по методу Бенталла-Де Боно с применением клапаносодержащего кондуита. Реконструкция дистального отдела аорты при остром расслоении по методу Hemiarch также конкурирует по надежности, безопасности и отдаленным результатам с полной заменой дуги аорты. С внедрением гибридных технологий выбор хирургической техники при расслоении аорты зависит от тяжести состояния больного, локализации проксимальной и дистальной фенестрации, распространенности диссекции аорты, степени дисплазии тканей аорты и аортального клапана, личного предпочтения и опыта хирурга. Ключевые слова: острое расслоение аорты, хирургическое лечение, выбор метода хирургического лечения.