Classical aortic valve replacement is often fraught with negative outcomes for patients. When replacing the aortic valve with a mechanical valve prosthesis, the patient is associated for life with the use of indirect anticoagulants, which often leads to hemorrhagic and thrombotic complications. In the case of replacement of the aortic valve with a biological prosthesis, a fairly frequent complication is early calcification and, consequently, a high frequency of dysfunctions of the biological prosthesis. In addition, mechanical and biological prosthetics of heart valves are quite expensive, which creates a serious economic load on the healthcare institution. But in the last decade, the technique of neocuspidization of the aortic valve with autopericardial flaps has been introduced into wide cardiac surgical practice, which is a clear alternative to prosthetics of heart valves.

The purpose of this study was to assess the effect of metabolic disorders on the effects of revascularization in patients with obliterating atherosclerosis. Materials and methods. The reconstruction was performed in 253 patients with femoral-tibial arterial segment lesion (98 open operations, 116 endovascular interventions and 39 patients were treated with hybrid technique). Results. Endovascular revascularization techniques are justified in case of disorders of carbohydrate metabolism. Conventional operations remain the method of choice in the case of those variants of atherosclerotic lesions, where minimally invasive techniques are impossible. Conclusions. Metabolic disorders in patients with peripheral atherosclerosis on the background of severe comorbid pathology may be the basis for choosing hybrid methods of revascularization.

Ewing’s sarcoma is a malignant bone tumor. It occurs more often in teenagers between 10–15 years old and metastasizes to the lungs and nervous system. Heart disease is atypical and occurs in only a few cases. We present a clinical case of late diagnosis of Ewing’s sarcoma in a 26-year-old patient with metastases in the left side of the heart. According to instrumental tests, hypermobile, ribbon-like formations were visualized on the cusps of the aortic and mitral valves with damage to the chordal apparatus. Coronary angiography was performed with embolextraction from the middle third of the left anterior descending artery and its diagonal branch, due to the clinical picture of anterior acute myocardial infarction with ST segment elevation. An urgent cardiac surgery was performed, in the attempt to prevent fatal incidents. During the revision, in addition to damage to the aortic and mitral valves of the heart, metastatic masses grew into the layer of the myocardium, the removal of which is technically impossible.In the early postoperative period, the patient died due to embolization into the brain and coronary arteries. Diagnosis of Ewing’s sarcoma requires timely diagnosis and treatment in order to prevent the rapid spread and development of life-threatening and fatal complications.