ТРАНСПЛАНТАЦИЯ СЕРДЦА У ПАЦИЕНТКИ С ПОСТТРАВМАТИЧЕСКОЙ АНЕВРИЗМОЙ ЛЕГОЧНОЙ АРТЕРИИ

Right heart catheterization (RHC) should be performed on all candidates in preparation for listing for cardiac transplantation. Patient, 64 y. o., with chronic heart failure NYHA III class, had developed a rare complication while performing that procedure – a rupture of segmental branch of pulmonary artery (PA) with pulmonary haemorrhage. The episode of pulmonary bleeding was stopped conservatively without surgical management. There was a pseudoaneurysm formation of segmental branch of PA 2,7 × 2,8 cm with signs of thrombosis. Afterfi ve months the patient underwent heart transplantation without severe complications in perioperative period. No more recurrent episodes of pulmonary haemorrhage were identifi ed.Обязательной процедурой, выполняемой перед включением кандидата на трансплантацию сердца в лист ожидания, является катетеризация правых отделов сердца и легочной артерии (ЛА). У пациентки 64 летс хронической сердечной недостаточностью III функционального класса по NYHA при выполнении данной манипуляции возникло редкое осложнение – разрыв сегментарной ветви ЛА с развитием легочного кровотечения. На фоне комплексной интенсивной терапии эпизод легочного кровотечения был купирован, не потребовав хирургического лечения. Сформировалась ложная аневризма сегментарной ветви ЛА размерами 2,7 × 2,8 см с признаками тромбирования. Спустя пять месяцев пациентка перенесла трансплантацию сердца, периоперационный период протекал без развития тяжелых осложнений, повторных эпизодов легочного кровотечения зафиксировано не было

HEART TRANSPLANTATION IN PATIENT WITH POST-RUPTURE PSEUDOANEURYSM OF SEGMENTAL BRANCH OF PULMONARY ARTERY

Right heart catheterization (RHC) should be performed on all candidates in preparation for listing for cardiac transplantation. Patient, 64 y. o., with chronic heart failure NYHA III class, had developed a rare complication while performing that procedure – a rupture of segmental branch of pulmonary artery (PA) with pulmonary haemorrhage. The episode of pulmonary bleeding was stopped conservatively without surgical management. There was a pseudoaneurysm formation of segmental branch of PA 2,7 × 2,8 cm with signs of thrombosis. Afterfi ve months the patient underwent heart transplantation without severe complications in perioperative period. No more recurrent episodes of pulmonary haemorrhage were identifi ed

FIRST EXPERIENCE OF APPLICATION OF ASSIST CIRCULATION DEVICE USING BIVENTRICULAR TYPE «EXCOR»

The frequency of use of assist blood device as the «bridge» to the heart transplantation increased in last years. An assessment of results of first 7 implantations of assist circulation device using biventricular type «Excor» was made. The implantations were performed in Federal Almazov centre of the heart, blood and endocrinology. An observation period after implantation was since 11 till 301 days. The heart transplantation of 4 patients was carried out in different terms after implantation. One of the patients passed away on the fifth day due to the pulmonary embolism. Another patient died on the eleventh day after the implantation because of multiple organ failure against the background of severe chronic cardiac failure. The waiting list of heart transplantation includes 2 patients