Disclaimer The EAC Guidelines represent the views of the EAC, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication. The EAC is not responsible in the event of any contradiction, discrepancy, and/or ambiguity between the EAC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the EAC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic, or therapeutic medical strategies; however, the EAC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient and, where appropriate and/or necessary, the patient’s caregiver. Nor do the EAC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient’s case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional’s responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.
Carotid stenosis is a multidisciplinary problem that requires the involvement of a specialists’ team, including cardiovascular surgeons, neurosurgeons, endovascular surgeons, cardiologists, neurologists, and internists. In this consensus statement, a group of experts considered the main stages of diagnosing carotid stenosis, as well as discussed, the necessary prevention methods and features of choosing the optimal treatment approach. The aim was to provide concise and structured information on the management of patients with carotid stenosis. This document was developed based on the updated clinical guidelines of the European Society for Vascular Surgery and the American Association for Vascular Surgery, taking into account the consensus opinion of Russian experts.
<p>Management of patients with terminal heart failure is one of the most serious ongoing problems in cardiac surgery. In addition, the clinical progression of heart failure is often characterized by cardiac rhythm disturbances, with atrial fibrillation and atrial flutter being the most common types of these disorders. The prognosis may be extremely unfavorable if inappropriate tactics of treatment is used. Development of interventional and minimally invasive surgery expanded the possibilities of treatment of such patients. The article looks at some application features of a hybrid approach to treatment of a patient with atrial flutter and a terminal stage of chronic heart failure.</p><p>Received 3 May 2017. Accepted 24 June 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p>
Aim. In the issue we report first in Russia experience of transcatheter “valve-invalve” implantation (TVIV) for treatment of severe tricuspid stenosis due to the structural deterioration of surgical tricuspid bioprosthesis.Material and methods. TVIV was performed in 4 high-risk redo patients (1 to 3 previous sternotomies) of various ages across (18-68 years) with structural deterioration of surgical tricuspid bioprosthesis.Results. Technical success was achieved in 100% cases. Diastolic gradients on tricuspid valve markedly decreased in all patients. Peak transtricuspidal gradient decreased from 20,4 to 10 mmHg in average. Clinical improvement as assessed by 6-minute walk test after TVIV was observed in 3 patients with congestive heart failure. In 1 patient with asymptomatic right ventricle dysfunction TVIV resulted in the enhancement of echocardiographic parameters.Conclusion. TVIV is a mininvasive alternative to conventional surgical tricuspid valve redo replacement. Based on available data including own experience TVIV should be considered an effective and safe treatment option for failed TV bioprostheses in high-risk patients of different age. Further studies are needed to assess long-term results of the method.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.