Резюме. В статье рассмотрен клинический случай транскатетерной коррекции вторичногодефекта межпредсердной перегородки (ДМПП) у 62-летней пациентки, осложнившийся миграцией окклюдера. Вторичный ДМПП был диагностирован 10 лет назад, определены показания к транскатетерной коррекции. В трансептальную позицию имплантирован окклюдер диаметром 12 мм. Спустя 48 часов окклюдера в септальной позиции не определялось. Окклюдер был обнаружен, захвачен и низведен в правую правую бедренную артерию. Выполнено дополнительное измерение размеров дефекта с использованием «sizing»-баллона. Имплантация окклюдера в септальнуюпозицию диаметром 22 мм. Ключевые слова: вторичный дефект межпредсердной перегородки, аневризма межпредсердной перегородки, транскатетерная коррекция, миграция окклюдера, пожилые пациенты, надрыв межпредсердной перегородки, измерительный баллон. Для цитирования: Гурьев ВВ, Зверев ДА. Транскатетерная коррекция аневризмы и двойного вторичного дефекта межпредсердной перегородки у пожилого пациента. Сибирское медицинское обозрение. 2018;(1): 88-91.Abstract. The article deals with the clinical case of transcatheter correction of the secondary interatrial septum defect (ASD) in a 62-year-old patient, complicated by the occluder migration. Secondary ASD was diagnosed 10 years ago, indications for transcatheter correction were determined. An occluder with the diameter of 12 mm was implanted in the transseptal position. After 48 hours, the occluder was not detected in the septal position. The occluder was discovered, captured and relegated to the right femoral artery. An additional measurement of the defect size with the use of a "sizing" -balloon was carried out. Implantation of the occluder into a septal position with the diameter of 22 mm. Key words: secondary defect of interatrial septum, aneurysm of interatrial septum, transcatheter correction, occluder migration, elderly patients, tear of interatrial septum, measuring balloon. Citation: Guryev VV, Zverev DA. Transcatheter correction of aneurysm and double secondary interatrial septum defect in an elderly patient. Siberian Medical Review. 2018;(1): 88-91. Транскатетерная коррекция аневризмы и двойного вторичного дефекта межпредсердной перегородки у пожилого пациента Transcatheter correction of aneurysm and double secondary interatrial septum defect in an elderly patient Гурьев В. В., Зверев Д. А. Guryev V. V., Zverev D. A. Siberian Medical Review. 2018;(1):88-91 Практическая медицина Pproblems of practical health care Сибирское медицинское обозрение. 2018;(1):88-91
РезюмеДля ознакомления представлен клинический случай одноэтапного эндоваскулярного лечения окклю-зии терминального отдела аорты и подвздошных артерий -синдрома Лериша. Осложнений в ходе лече-ния не было. Пациент выписан в удовлетворительном состоянии. Подробно описана техника выполнения операции. Таким образом, этим методом возможно эффективно и безопасно выполнить лечение синдро-ма Лериша и, в отличие от открытых реконструктивных вмешательств, с меньшей травматичностью.Ключевые слова: эндоваскулярное лечение; стентирование подвздошных артерий; синдром Лериша.Для цитирования : Трансляционная медицина. 2017; 4 (3): 12-16.
A comparative assessment of knee joint alloplasty (KJA) results in patients with gonarthrosis with and without concomitant pathology of type 2 diabetes mellitus (DM 2) was carried out. The data of 104 patients were analyzed, who underwent prosthetics of the knee joints in 2003-2020 at the Center for Traumatology and Orthopedics at the Semashko Russian Railways Hospital (mean age 65,2 (10,5) years, mean observation period — 14 years, from 4 to 17 years). Primary total knee arthroplasty was performed with cement prostheses manufactured by Biomet (Aigisi, Avangard) and Eskulap. The patients were divided into 2 groups: group 1 - 56 patients without signs of DM, group 2 — 48 patients with DM. Comparison of the characteristics of patients without diabetes and with DM2 who underwent KJA showed that there were no signifcant differences in the incidence of intraoperative complications; patients with DM2 had slightly longer inpatient treatment and frequency of postoperative complications. Analysis of the clinical and functional state using the Knee Society Score indicated that in patients without diabetes the dynamics of improvement in the functional status of the knee joint was slightly more pronounced, and after 1 year there were statistically signifcant differences in terms of this scale. Evaluation of long¬term complications over a long observation period showed that the absolute majority of patients in both groups had no complications; however, in the group of patients with diabetes, the proportion of patients without complications was slightly lower than among patients without DM: 25,0 and 5,4% respectively. It was concluded that, during the decision-making on arthroplasty, surgical risk should be assessed for patients with diabetes, taking into account possible complications and the presence of other associated diseases. One of the main goals of the preoperative preparation of the considered patient category should be the stabilization of the blood plasma glucose level.
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