The article deals with the plasma‐assisted chemical vapor deposition of 0.3–1.4 μm thick a‐C:H:SiOx films in a mixture of argon and polyphenylmethylsiloxane vapor onto the Ti–6Al–4V alloy substrate, which is often used as an implant material. The a‐C:H:SiOx film structure is studied by the Fourier‐transform infrared and Raman spectroscopies. The pull‐off adhesion test assesses the adhesive strength of a‐C:H:SiOx films, and the ball‐on‐disk method is employed to measure their wear rate and friction coefficient. According to these studies, a‐C:H:SiOx films are highly adhesive to the Ti–6Al–4V substrate, have low (0.056) friction coefficient and wear rate (9.8 × 10−8 mm3 N−1 m−1) in phosphate‐buffered saline at 40°C. In vitro studies show neither thrombogenicity nor cytotoxicity of the a‐C:H:SiOx film for the human blood mononuclear cells (hBMNCs). The in vitro contact between the hBMNC culture and a‐C:H:SiOx films 0.8–1.4 μm thick deposited onto Ti–6Al–4V substrates reduces a 24‐hour secretion of pro‐inflammatory cytokines and chemokines IL‐8, IL‐17, TNFα, RANTES, and MCP‐1. This reduction is more significant when the film thickness is 1.4 μm and implies its potential anti‐inflammatory effect and possible application in cardiovascular surgery. The dependence is suggested for the concentration of anti‐inflammatory cytokines and chemokines and the a‐C:H:SiOx film thickness, which correlates with the surface wettability and electrostatic potential. The article discusses the possible applications of the anti‐inflammatory effect and low thrombogenicity of a‐C:H:SiOx films in cardiovascular surgery.
The results of evaluation of the quality of life of 40 CHD patients with severe left ventricular myocardial dysfunction after coronary bypass surgery are presented. Their quality of life was assessed at baseline, at 1, 3, 5 and 7 years by means of SF-36 questionnaire. The data obtained show that these patients' quality of life significantly drops at baseline, and the lower the quality of life, the higher the patients' functional class of angina and heart failure. It was found out that coronary bypass surgery contributes to the improvement of the quality of life of patients with CHD and low myocardial contractility of the left ventricle.
Представлен мировой опыт использования операционного микроскопа при коронарном шунтировании. Приведены данные, свидетельствующие о важной роли применения операционного микроскопа и микрохирургической техники для выполнения коронарных анастомозов. Благодаря высокому оптическому увеличению формирование коронарных анастомозов стало более точным, что положительно сказывается на послеоперационной проходимости шунтов. Ключевые слова: операционный микроскоп, микрохирургическая техника, коронарное шунтирование, проходимость шунтов.
<p><strong>Aim:</strong> Emphasis in this study was placed on clinical and functional assessment of a modified "Florida Sleeve" procedure during surgical correction of ascending aorta aneurysms with concomitant aortic insufficiency.<br /><strong>Methods:</strong> 32 patients with an aneurysm of the ascending aorta and aortic insufficiency underwent a modified "Florida Sleeve" procedure. The average follow-up was 17 (0-60) months. The average age of patients was 57±13 (23-73) years 56±13 years.<br /><strong>Results:</strong> The expected 4-year cumulative survival rate was 84.3%. Overall freedom from aortic insufficiency in the late period was 88.9%. Median aortic regurgitation was 1+ (1; 2). Long-term follow-up revealed no valve-associated complications.<br /><strong>Conclusion:</strong> The aortic root reimplantation procedure enables optimal correction of the existing lesions of the aortic root without performing aortic valve replacement and demonstrates stable clinical and functional outcomes in the long-term period.</p><p><strong>Key words:</strong> aortic aneurysm; aortic valve; valve-sparing operations.</p><p><strong>Funding</strong></p><p>The study had no sponsorship.</p><p><strong>Conflict of interest</strong></p><p>The authors declare no conflict of interest.</p>
Background: The effectiveness of additional stenting of the distal aorta as compared to conventional surgery alone in type A aortic dissection (TAD) has yet to be proven.
Methods:We conducted this multicenter comparative study to evaluate the effects of antegrade bare stenting of the dissected aorta beyond the distal anastomosis with a Djumbodis ® device system (DDS).Outcomes that were measured included early outcomes, overall mortality from aortic cause and late aortic events including re-interventions. A consecutive series of 134 patients operated on in two participating centers were distributed into study and control groups according to the treatment received: conventional surgery with DDS (DJ group, n=42) or without (control group, n=92).Results: Operative mortality was 21.4% and 17.6% in the DJ and control groups, respectively (P=0.9), and was within pre-specified alarm lines for both groups. In multivariate analysis, the only independent predictor of operative mortality was the presence of any complication (cardiac tamponade or malperfusion, P=0.05), which occurred more in the DJ group (OR =1.3; non-significant). Sixty patients were included into the matched survivors cohorts study (propensity scoring). The aortic event-free survival at 7 years for early survivors was 77%±10% and 48%±11% in the matched DJ group and control group, respectively (HR =0.66). Late mortality from an aortic cause was 10% and 20% in the matched DJ group and control group, respectively (RR =0.5). Actuarial freedom from aortic or vascular interventions was 71%±10% and 67%±9% in the matched DJ and control group, respectively. Operative mortality was not influenced by the use of DDS as compared to conventional surgery alone for TAD.
Conclusions:We observed a trend towards better organ perfusion in the DJ group postoperatively, and more aortic events and deaths of aortic cause in the control group during follow-up.
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