Introduction. One of the main unresolved problems in coronary surgery has been the search for an “ideal” graft for coronary artery bypass surgery. Surgical procedures with the use of artificial circulation can lead to high incidence of postoperative complications compared to operations on a beating heart. The aim. To study the results of total arterial myocardial revascularization on a beating heart and to evaluate the medium-term outcomes in patients with coronary heart disease. Materials and methods. Ninety eight patients with coronary heart disease were treated from 2009 to 2013. The patients underwent total arterial myocardial revascularization on a beating heart using only arterial grafts: those obtained from internal thoracic artery, radial artery, and right gastroepiploic artery. Results and discussion. No deaths were observed in the postoperative period. In 91 (92.8%) patients, the postoperative period was uneventful. After 5 years of follow-up, clinical and non-invasive methods of examination revealed no coronary circulation disorders. Conclusions. Our clinical experience showed promising short- and medium-term results. The technique of total arterial myocardial revascularization on a beating heart is a good alternative to operations performed under the condition of artificial circulation.

No abstract

The gold standard treatment for end-stage heart and kidney failure is simultaneous heart and kidney transplantation. The global number of recipients on the waiting list and performed organ transplants increases annually. However, there is a lack of well-defined selection criteria for multi-organ transplants, leading to variations based on geographic region and local protocols. In this study, we present our initial experience with simultaneous heart and kidney transplantation in Patient P, a 51-year-old individual with severe calcification of the mitral valve and end-stage chronic kidney disease. Surgical correction was not possible, and thus the patient underwent orthotopic simultaneous heart and kidney transplantation. During the early postoperative period, the patient experienced acute renal failure in the transplanted kidney, which was managed through courses of hemodialysis. The findings of this clinical observation represent the first experience of multi-organ transplantation in Ukraine. Our clinical observation illustrates the successful feasibility of simultaneous orthotopic heart and kidney transplantation, showcasing promising immediate and medium-term follow-up results.

The heart transplantation in early period after ending of a COVID-19-associated pneumonia

Introduction. Aortic valve disease is often combined with the ascending aortic aneurysm. According to a number of authors, the frequency of the diagnosis varies from 9 to 50%, and the condition requires one-stage surgical correction. Typically, in these cases, mechanical or biologic prostheses are used. The Ozaki procedure allows such operations to be performed without replacing the aortic valve with an artificial prosthesis. The aim. To analyze the results of aortic valve reconstruction using the Ozaki technique combined with ascending aortic aneurysm repair. Materials and methods. The article describes the first experience of treatment of 12 patients with aortic valve disease and ascending aortic aneurysm. All the patients underwent Ozaki procedure modified by J. Benedik with surgical correction of aneurysm of the ascending aorta and the aortic arch. Results and discussion. No deaths were observed in the postoperative period. There was no conversion to aortic valve replacement. Ultrasound imaging after 3 and 6 months revealed no aortic valve dysfunction. Clinically, patients’ well-being was satisfactory and they returned to normal life. Long-term results of these operations interventions require further study. Conclusions. Our first clinical experience showed promising short- and medium-term results. The indications for aortic valve reconstruction are the same as those for valve replacement with a bioprosthesis. Ozaki procedure can be successfully combined with ascending aortic aneurysm repair. The main advantage is the absence of a frame that does not narrow the opening area of the valve and preserves the aortic root function, which is very important for patients with a narrow aortic root.