The new devitalizing technology seems effective in decreasing immune response to homologous tissue. It does not affect elasto-mechanic properties and collagenous structure of allografts. The presented data stimulate interest to the anticalcinosis devitalisation technology as an affective tool for improving biocompatibility of allografts.
Background. The use of radiation therapy for the treatment of tumors of the chest сan lead to the development of cardiac pathology, including that of the valves and coronary arteries. Study aim: to analyze the specifics of post-radiation lesions of the valvular apparatus and coronary arteries, and to assess the immediate results and risks of surgical correction of detected defects. Materials and methods. In the Emergency department of surgery of acquired heart disease of A. N. Bakulev National Medical Research Center of Cardiovascular Surgery in the period from 2004 to 2017 were examined and operated 46 patients aged 35–81 years (mean age 56±12.4 years, 80 % women). The period from primary irradiation of the chest to surgical treatment of valvular pathology ranged from 4 to 40 years. Indications for thoracic radiotherapy were Hodgkin’s lymphoma in 23 patients (50 %), breast cancer – in 20 (43 %). Results. Stenosis of the aortic valve was the leading defect in 42 patients (91 %). According to coronary angiography, coronary artery disease was diagnosed in 31 patients (67 %). Isolated aortic valve prosthesis was performed in 14 (30 %) patients, other operations were combined. Hospital mortality was 11 % (5 patients). There were no deaths among patients who underwent radiation therapy after mastectomy. Main nonlethal complications were: pericardial effusion in 6 patients (13 %), hydrothorax requiring repeated pleural punctures in 5 patients (11 %). Conclusion. The variety of clinical manifestations of radiation heart disease and its progressive nature emphasize the need for long-term dynamic observation of patients after thoracic irradiation in order to timely identify the pathology and eliminate the risk of sudden cardiac complications and the development of severe heart failure decompensation.
Cement embolism of the right chambers of the heart after vertebral surgery is an extremely rare complication and occurs in 4 % of cases. The strategies for choosing the treatment of this complication are open-heart surgery under conditions of cardiopulmonary bypass, conservative treatment, or endovascular support. In the case of a fatal complication of embolism, such as perforation of the heart with the development of tamponade or life-threatening arrhythmias, the patient is shown an open operation with infrared. According to the literature, only 14 such operations are described, performed to save the patient’s life. We performed a successful operation of embolectomy from the right heart chambers in a 69‑year-old patient who had previously undergone vertebroplasty of the thoracic vertebrae.
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