Протезирование клапанов сердца и необходимость в интраоперационном ультразвуковом мониторинге операций

This article focuses on the necessity of use Intraoperative Transesophageal Echocardiography (IOTEE) in valve replacement surgery. The authors present comparative estimation of IOTEE and the method of visual surgical revision in the intraoperative detection of paravalvular leaks.Статья отражает данные о целесообразности применения метода интраоперационной чреспищеводной эхокардиографии при протезировании клапанов сердца. Приведена сравнительная оценка метода интраоперационной чреспищеводной эхокардиографии и метода визуальной хирургической контрольной ревизии в интраоперационной диагностике парапротезных сообщений

Immediate and long-term results of the left atrium auricle occluder implanting in atrial fibrillation

Aim. To evaluate the safety and efficacy of the “WATCHMAN” occluder (OW) in atrial fibrillation patients (AF) during hospital period and in 12 months after the procedure. Material and methods. Fr_m 2013 to 2015 years, in the N. A. Semashko Central clinical hospital ù 2 of “RZD”, 15 OW were implanted to patients with persistent AF of non-rheumatic origin, admitted for electro cardioversion, or electrophysiological study and radiofrequency ablation, pacemaker implantation. Indications for endovascular intervention were the threat of repeated embolism, high bleeding risk, severe comorbidities, and inefficacy of antithrombotic therapy. From the study were excluded those with stenosis of the left atrioventricular space and thrombi in the left atrium auricle (LAA). During pre-surgery period, all patients underwent standard transthoracal and transesophageal echocardiography for assessment of the LAA anatomy, its size in four points of view and its position to the left upper pulmonary vein. For stroke risk assessment and of thromboemolic complications the score CHA2DS2 was used and its new edition CHA2DS2-VASc. Before the discharge from clinic, all patients underwent transesophageal echocardiography, repeated in 6 weeks, 6 and 12 months. Results. Mean age of patients was 52 year old. All patients had successful OW implanting. Interventions were done without general anesthesia, under local anesthesia. Mean duration of surgery was 42±11,3 min. To every patient one device was utilized. There were no replacements of OW for wrong sizing or other reasons. In 5 patients (anatomy as “chicken wing”) under angles 90-135º there was protrusion of lower border of OW found by 1/3 of the length. In patients with LAA OW sizes 33 and 27, there was residual flow registered under the lower border, of 5 mm and 2 mm diameter, respectively. There were no complications during operation and nearest post-operation period. In 12 months after the study there was not dislocation, embolization or position changes among the devices. The residual flow diameter in 33 mm implant patient decreased in 6 months from 5 to 2 mm, in the other — remained 2 mm. No patients had brain circulation disorders and other embolies. Conclusion. The method of OW implanting into LA of non-rheumatic origin is effective method of embolic complications prevention, not followed by bleedings and making to prognosis improvement of this kind of patients, as to quit entire life anticoagulation. © Russian Journal of Cardiology

Immediate and long-term results of the left atrium auricle occluder implanting in atrial fibrillation

Aim. To evaluate the safety and efficacy of the “WATCHMAN” occluder (OW) in atrial fibrillation patients (AF) during hospital period and in 12 months after the procedure. Material and methods. Fr_m 2013 to 2015 years, in the N. A. Semashko Central clinical hospital ù 2 of “RZD”, 15 OW were implanted to patients with persistent AF of non-rheumatic origin, admitted for electro cardioversion, or electrophysiological study and radiofrequency ablation, pacemaker implantation. Indications for endovascular intervention were the threat of repeated embolism, high bleeding risk, severe comorbidities, and inefficacy of antithrombotic therapy. From the study were excluded those with stenosis of the left atrioventricular space and thrombi in the left atrium auricle (LAA). During pre-surgery period, all patients underwent standard transthoracal and transesophageal echocardiography for assessment of the LAA anatomy, its size in four points of view and its position to the left upper pulmonary vein. For stroke risk assessment and of thromboemolic complications the score CHA2DS2 was used and its new edition CHA2DS2-VASc. Before the discharge from clinic, all patients underwent transesophageal echocardiography, repeated in 6 weeks, 6 and 12 months. Results. Mean age of patients was 52 year old. All patients had successful OW implanting. Interventions were done without general anesthesia, under local anesthesia. Mean duration of surgery was 42±11,3 min. To every patient one device was utilized. There were no replacements of OW for wrong sizing or other reasons. In 5 patients (anatomy as “chicken wing”) under angles 90-135º there was protrusion of lower border of OW found by 1/3 of the length. In patients with LAA OW sizes 33 and 27, there was residual flow registered under the lower border, of 5 mm and 2 mm diameter, respectively. There were no complications during operation and nearest post-operation period. In 12 months after the study there was not dislocation, embolization or position changes among the devices. The residual flow diameter in 33 mm implant patient decreased in 6 months from 5 to 2 mm, in the other — remained 2 mm. No patients had brain circulation disorders and other embolies. Conclusion. The method of OW implanting into LA of non-rheumatic origin is effective method of embolic complications prevention, not followed by bleedings and making to prognosis improvement of this kind of patients, as to quit entire life anticoagulation. © Russian Journal of Cardiology

Magnetic, optical and photothermal properties of Fe3O4 and CoFe2O4 nanoparticles coated with organic materials

Nanoparticles represent a class of highly adaptable nanostructures with a remarkable surface-to-volume ratio, allowing for the precise tuning of their shape to influence their properties. Moreover, their surfaces can be functionalized with organic or inorganic materials, thereby tailoring their performance and introducing specific functionalities. Iron oxide nanoparticles including Fe3O4 and spinel Co ferrites emerge as promising candidates for medical applications due to their notable biocompatibility and appropriate magnetic properties. Their potential in cancer therapy primarily hinges on localized cancer cell heating, which can be remotely triggered by an external AC magnetic field (magnetic hyperthermia). Additional heating induced by light excitation can reduce the required particle dosages during such treatments. The optical characteristics of iron oxide nanoparticles within the wavelength range of biological transparency open up exciting prospects for utilizing these structures in adjuvant thermal therapies. In this study, we demonstrate the results of synthesis and study of magnetic and optical properties of iron oxide nanoparticles coated with organic materials. Notably, CoFe2O4 nanoparticles coated with dihydrocaffeic acid demonstrated the coefficient of heat efficiency conversion close to 100 % under 810 nm laser excitation. They also demonstrated the magnetization curves characterized by minimal hysteresis and remanent magnetization typical of superparamagnetic behavior of iron oxide nanoparticles. This suggests their potential for combined magnetic and optical hyperthermia

Ganges in crystal structure of fullerene films at alloying and radiation defect formation

The crystal structure of the C₆₀ fullerene films with their alloying by the oxygen molecules and copper atoms in studied and under the influence of high energy eletron irradiation (Ee = 1.8 MeV) is investigated. It is shown that the crystal structure of the C₆₀ and C₇₀ films changes in the dependence on the concentration of impurity elements and radiation damages substantially infuluences the electronic and vibration spectra of fullerenes and is the result of the appearance in this case of additional Coulomb intermolecular interaction

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

Background: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagonlike peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. Methods: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallelgroup, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. Results: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m2, and duration of T2DM was 9.3±8.2 years. The qualifying ACS wasamyocardial infarctionin83% and unstableangina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. Conclusion: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk. © 2015 Elsevier Inc. All rights reserved