Simultaneous surgical correction of atrial fibrillation and aortic valve replacement: immediate results after surgery

Aim — To assess the results of simultaneous surgical correction of atrial fibrillation and aortic valve replacement. Materials and Methods — The retrospective analysis was held for the period of 2009-2016 of patients with atrial fibrillation (AF) and pathology of the aortic valve after combined operations. 68 patients were included in the study, the average age was 56 (51; 64) years; men 53%, women 47%. All patients were in III-IV functional class by NYHA classification. The duration of AF was 34 (24; 58) months. AF: persistent in 70,6%, paroxysmal in 29,4%. Calculated risks comprised: Euro Score II – 3,8 (2,4; 5,6), the risk of in-hospital mortality and the risk of total mortality by Ambler - 5,5 (3; 7,3) and 8 (6; 9), respectively. Results ― The average number of simultaneous procedures per one patient was – 4 (4; 4), minimum – 3, maximum – 5. In 100% cases was performed aortic valve and mitral valve correction and Maze IIIB procedure. CABG was performed in 20,6% of cases and tricuspid valve repair was performed in 67,6%. The total duration of operations was 6.3 ± 1.4 hours, the time of CPB: 208 (168; 224) min, aortic clamping time: 126 (119; 151) min. In-hospital mortality was 4.4%. The main non-lethal complications in the early postoperative period were heart failure, respiratory and renal insufficience, hemorrhage and transient neurological disorder. Conclusions ― There are few data demonstrating experience in performing of such complex surgical cases due to the severity of patients and small number of institutions having such experience. In our series of hospital mortality observations correlated with the calculated and accounted for 4.4%, which is an acceptable result in this group of patients

Rarely naturalized, but widespread and even invasive: the paradox of a popular pet terrapin expansion in Eurasia

The North American terrapin, the red-eared slider, has globally recognized invasive status. We built a new extensive database using our own original and literature data on the ecology of this reptile, representing information on 1477 water bodies throughout Eurasia over the last 50 years. The analysis reveals regions of earliest introductions and long-term spatio-temporal dynamics of the expansion covering now 68 Eurasian countries, including eight countries reported here for the first time. We established also long-term trends in terms of numbers of terrapins per aquatic site, habitat occupation, and reproduction success. Our investigation has revealed differences in the ecology of the red-eared slider in different parts of Eurasia. The most prominent expression of diverse signs of invasion success (higher portion of inhabited natural water bodies, higher number of individuals per water body, successful overwintering, occurrence of juvenile individuals, successful reproduction, and establishment of populations) are typical for Europe, West Asia and East Asia and tend to be restricted to coastal regions and islands. Reproduction records coincide well with the predicted potential range based on climatic requirements but records of successful wintering have a wider distribution. This invader provides an excellent and possibly unique (among animals) example of wide alien distribution, without the establishment of reproducing populations, but through the recruitment of new individuals to rising pseudopopulations due to additional releases. Therefore, alongside the potential reproduction range, a cost-effective strategy for population control must take in account the geographical area of successful wintering. Graphical abstrac