ON SOME ASPECTS IN ULTRASONOGRAPHY OF THE UPPER ABDOMEN

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INFLUENCE OF IMMUNOREACTIVITY TYPE UPON POSTOPERATIVE STATUS OF PATIENTS WITH COLO-RECTAL CANCER (CRC)

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EVALUATION OF GASTRIC EMPTYING IN REFLUX DISEASE AND DUODENAL ULCER PATIENTS

Thirty healthy volunteers, 77 hiatus hernia and reflux disease patients as well as 26  duodenal ulcer ones were studied by means of echographic planimetry and volumetry of antrum and corpus ventriculi and gamma camera as well in order to evaluate the gastric emptying before and after surgery. The mean semi-emptying antral time after esophagocruroplasty plus frontal semi-fundoplication was determined as 9,5 min whereas after Nissenfundoplication it reached the rate of 19,2 min (range 8-32 min; p < 0,001). The latter was related to a higher incidence rate of postoperative stomach bloating complaints with the N is sen patients. Ultrasound measurements of gastric emptying were of comparable sensitivity to scintigraphy in quantifying the fluid bolus evacuation

Surgical remodelling of the left ventricle - theory and practice in the Department of Cardiac Surgery in `Sveta Marina` University Hospital, Varna, Bulgaria

Early and aggressive treatment of acute myocardial infarction (MI) results in a decrease of the incidence of late complications. Nowadays the evolution of about 7.6% of all cases of transmural MI of the left ventricle (LV) results in aneurysm formation. The aneurysm itself as well as other consequences of the myocardial loss is related to impaired systolic and diastolic LV function, risk of rupture of the LV wall or potentially embologenous thrombosis in the LV cavity.These characteristics contribute to a constant trend towards timely and contemporary surgical treatment of this category of patients in terms of operative strategy and technique. It also stimulates the conduction of large and powerful trials in this field and the creation of databases including the early, midterm and late outcomes that further enhance the understanding of the most suitable treatment algorithm. Since the first surgical procedures in the 1950s the techniques have evolved offering an individualized approach as each procedure is distinguished for its surgical complexity and achieved results.Along with the descriptive characteristics of the evolution of surgical techniques for correction of LV aneurysms the current text also presents the experience of the Department of Cardiac Surgery in `Sveta Marina` University Hospital in Varna, Bulgaria with the surgical remodeling of the LV and the early results in this patients category. During the period 01.01.2008 - 31.12.2013 a total of 22 patients underwent myocardial revascularization and repair of LV aneurysm, 8 with linear repair and 14 with Dor procedure. 87.5% (7/8) of the patients with linear repair and 85.7% (12/14) of these with Dor procedure survived the early postoperative period and presented with significantly reduced postoperative volumes and improved function of the LV. Despite the small number of cases this proves both techniques ensure acceptable surgical results for these severely ill patients.Key words: left ventricular aneurysm, surgical remodelling of the left ventricl

Analysis of the Results of the Introduction of the Protocol for Prevention of Wound Complications After Heart Surgery

We present our results after the implementation of the protocol for prevention of wound complications following open heart surgery introduced in the Department of Cardiac Surgery, University Hospital „St. Marina`, Varna in January 2014, as well as short data from our studies of risk factors for wound infection.Aim: The aim of this paper is introduction of a uniform protocol for assessing preoperative risk, preparing patients for surgery, behavior in the operating room and in the postoperative period to reduce the incidence of postoperative infection of the chest wound and thus enhancing the quality of life of patients, reducing the hospital stay and optimizing the financial costs; identification of risk factors for wound infection and analysis of the epidemiology of postoperative wound infections.Materials and Methods: We conducted studies on potential risk factors responsible for the development of postoperative wound infection of the chest wall in 1354 consecutive patients from January, 2011 to September, 2013 and 505 patients from January, 2014 to December, 2014. Standard descriptive statistics were used.Results: After processing the data and a comparison with a control group we found that the proportion of wound infections before the introduction of the protocol for the prevention of wound complications (cases 2011-2013) is greater than the proportion of wound infections after its introduction.The following can be marked can be marked as significant risk factors for wound infection after cardiac surgery operation in our clinic: diabetes mellitus, BMI> 25, the duration of mechanical pulmonary ventilation in the ICU, chronic congestive heart failure and low albumin levels.Conclusions: Strict compliance with the protocol for the prevention of wound infection leads to a significant reduction in wound complications.The risk factors for wound infection that we find significant within our clinic are comparable to the reported sources in the world.The reduction in body weight and strict glycemic control would reduce the risk of wound complications

Prevalence of comоrbidities in a cohort of patients with hemodynamically significant, pure aortic stenosis and sinus rhythm, admitted to cardiosurgery for a primary, isolated aortic valve replacement

Once judged a degenerative disease, aortic valve stenosis is now believed to be very similar in terms of pathogenesis to atherosclerosis. This initial plaque of aortic stenosis is alike that of coronary artery disease. Risk factors associated with coronary artery disease - including age, male sex, hyperlipidaemia, and evidence of active inflammation - are held in common by the two disorders. Over the past decade a new hypothesis was coined, that comorbidities such as overweight/obesity, diabetes mellitus, chronic obstructive pulmonary disease, and salt-sensitive hypertension induce a systemic proinflammatory state wich, in turn, favours hypertrophy development. The latter contributes to high diastolic left ventricular stiffness and heart failure development. Comorbidities, along with other important biological markers, are proposed to be included in diagnostic algorithms. It is expected that comorbidities may have an important impact on the prognosis after aortic valve remplacement in patients with calcific aortic valve stenosis. In the current paper, we analyse the comorbidity profile amont patients with hemodynamically significant, pure aortic stenosis and sinus rhythm, admitted to cardiosurgery clinic for primary, isolated aortic valve replacement.Key words: aortic valve stenosis, aortic valve replacement, comorbidit

Abstracts of the 20th annual meeting of the association `Heart - Lung` and 2nd „Varna - Augsburg` conference 30-31 may 2014

Primary tumours of the heart are rare. Metastases are the most frequent tumours of the heart. Anyway, it is generallyagreed that autopsy prevalence of primary cardiac tumors is 1 out of 2,000 and that of secondary cardiactumors is 1 out of 100 autopsies, with a secondary/primary cardiac tumors ratio of 20:1. Cardiac tumors may occurin any cardiac tissue. They can cause valvular or inflow-outflow tract obstruction, thromboembolism, arrhythmias,or pericardial disorders. Symptoms are very variable and can be the result of either local or systemiceffects. Surgery is successful for benign tumours when adequate resection margins are allowed. A number of imagingmodalities are available for the assessment of cardiac tumours; each has advantages and limitations. Thisreport presents our experience in the treatment of tumors of the hear