Sinus of Valsalva aneurysm (SVA) is an uncommon and mostly congenital cardiac anomaly which predominantly affects Asian males [1]. Congenital SVA is caused by deficiency of normal elastic tissue between aortic media and the annulus fibrosus (abnormal bulbus cordis development) [2]. Ventricular septal defect (VSD), aortic regurgitation (AR), and bicuspid aortic valve (BAV) are frequent concomitant lesions in this SVA type. Acquired SVA can result from previous cardiac surgery, endocarditis, syphilis, atherosclerosis, or chest injury [3]. SVA arises from the right sinus of Valsalva in 80-85% cases, from the non-coronary sinus in 5-15%, and rarely from the left sinus. Despite being generally asymptomatic, SVA can compress adjacent structures, resulting in acute

Surgical myectomy, dual-chamber pacing and alcohol septal ablation are equally effective in reducing obstruction in case of correct indications. Dual-chamber pacing is indicated in functional reversible states characterized by excitation delay. Alcohol septal ablation is preferable in cases with midventricular obstruction and appropriate coronary anatomy. Surgical methods are indicated in anatomical irreversible changes and remain the gold standard for obstructive hypertrophic cardiomyopathy treatment.

The study aimed to analyze kidney function for patients with complicated forms of coronary artery disease (CAD) in the perioperative period. Methods. It was a retrospective analysis of 110 high-risk patients with complicated forms of CAD, who were operated on and discharged from the National M. Amosov Institute for the period from 2009 till 2019 years. Kidney function was evaluated by glomerular filtration rate (GFR), calculated online with СKD-EPI formula. Results. Among the included patients there were 86 (78.1%) patients with metabolic syndrome, 81 (73.59%) patients with disorders of glucose metabolism, 82 (74.5%) subjects with chronic obstructive pulmonary disease and 38 (34.5%) patients had chronic kidney disease (CKD) 3-5 stage. Preoperative risk stratification with EuroScore II scale was 9.4%. All operations performed in cardiopulmonary bypass; Custodial cardioplegia was used in 53 (48.1%) patients. The average perfusion time was 111 minutes, average cross-clamping time was 73.9 minutes. Acute kidney injury in the early postoperative period had 9 (8.1%) patients. Conclusions. At the admittance 38 (34.5%) patients with complicated forms of CAD had CKD 3-5 st. Analysis of the GFR dynamic in the early postoperative period shown a decrease in GFR in 71.05% of patients. Transient acute kidney injury with 50% sCr growth had 9 (8.1%) patients but didn’t require hemodialysis.

Neurological disorders are the most serious and debilitating complications of the postoperative period in cardiac surgery. The main clinical manifestations of cerebral dysfunction are as follows: stroke, decreased cognitive function, encephalopathy and depressive disorder. The aim. To perform a literature review of neurological complications after coronary artery bypass grafting (CABG) in high-risk patients. Results. The main neurological complications after CABG in high-risk patients were considered. The main pathophysiological mechanisms of development of cerebral circulation disorders in the form of macro- and microembolization, hypoperfusion secondary to hypotension and systemic inflammatory response have been determined. According to the literature, the incidence of stroke in the postoperative period is 1.5–6%, and it increases in the elderly. It’s important to perform carotid arteries ultrasound before CABG. According to the literature, carotid stenosis greater than 60% is found, depending on the age group, in 7–12% of patients. There is an ongoing debate around the world regarding the method and time of carotid atherosclerosis surgery (before revascularization, during or after CABG). Newman and co-authors have shown that in 5 years after myocardial revascularization, 41% of patients have a decrease in cognitive function, and it is lower than it was before surgery. Opponents of on-pump CABG have hypothesized the occurrence of Alzheimer’s disease after surgery with extracorporeal circulation, but authors from Mayo Clinic have investigated this question and refuted this theory; Canadian researchers have even proved the positive effect of revascularization on prevention of Alzheimer’s disease. The main strate­ gy for the prevention of cerebral complications is an individual approach for each high-risk patient.

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