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Khirurgii

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Year 2014 Vol. 22 No 3

EXCHANGE OF EXPERIENCE

V.V. SELESNEV1, N.S. MIKUTSKI2, P.F. CHERNOGLAZ2,L.G. SHESTAKOVA2, A.S. ZHIGALCOVICH2 , YU.P. OSTROVSKY1

THE URGENT ANGIOSURGICAL PROBLEMS IN CARDIAC SURGERY CLINIC

SEE “Belarusian Medical Academy of Postgraduate Education” 1,
SE RNPC “Cardiology”2 , Minsk,
The Republic of Belarus

Objectives. To evaluate the character and frequency of angiological complications in cardiac surgery clinic after invasive interventional surgeries as well as to determine the measures of their preventions and methods of elimination.
Methods. The work result of the cardiosurgical clinic of Republic Scientific Practical Centre “Cardiology” has been analyzed. During the recent years (2011-2012) 5537 operations on the open heart and major vessels, 2234 coronary angiographies, 804 of coronary artery stenting, 221 stenting of periferal, renal, visceral arteries, 34 stenting of thoracic and abdominal aorta, 103 intraaortic balloon counter pulsation procedures, 18 extracorporeal membrane oxygenation, 10 paracorporeal and implantable heart bypasses, 72 sessions of ultrafiltration of the blood, 9 acute hemodialysis sessions have been performed.
The analyses of reports from the profile departments is carried out as well as of cases history, reports of interventions, procedures, investigations in case of angiological complications development demanding on the operative correction. Such complications as bleeding, strained hematoma, pseudoaneurisms, perforations and thromboses of the vessels have been registered.
Results. During the period 2011-2012 yrs. the frequency of vascular complications after coronary angiography made up the following: 27 of cases (1,2%) – strained thigh hematoma, 2 cases – the shoulder strained hematoma, 19 cases – false aneurysm of the femoral arteries, 5 cases – humeral artery thrombosis (as an access), 1 case of the distal bed embolism. At the stenting of the thoracic and abdominal aorta (34 interventions) 1 complication was registered (2,9%) – perforation of the iliac segment during the delivery system application, eliminated by means of the open intervention such as the defect suturing. The complications requiring surgical correction and associated with intra-aortic balloon counter pulsation have not been registered in 2011-2012 yrs.
Conclusions. In cardiosurgical clinics taken into consideration the character of profile pathology and wide use of intervention methods of diagnostics and treatment the different vascular complications can occur including those dangerous for life demanding on adequate and well-timed surgical correction. To reduction the incidence of complications mentioned above, it is advisable the concentration of the collective efforts of cardiovascular surgeons, endovascular internists, the introduction of current technologies and procuring by highly qualified professionals.

Keywords: cardiosurgical clinic, angiological complications, prevention, correction
p. 374 – 378 of the original issue
References
  1. Von Segesser LK. The contraindications of today are the indications of tomorrow. Eur J Cardiothorac Surg. 2013 Apr;43(4):665–72.
  2. Mrochek AG, Patseev AV, Ermolkevich FF, Bel'skaia MI. Dostizheniia kardiologicheskoi sluzhby Respubliki Belarus' [Achievements of cardiology service of the Republic of Belarus]. Kardiologiia v Belarusi. 2012;(4):8–21.
  3. Jeremias A1, Gruberg L, Patel J, Connors G, Brown DL. Effect of peripheral arterial disease on in-hospital outcomes after primary percutaneous coronary intervention for acute myocardial infarction. Am J Cardiol. 2010 May 1;105(9):1268–71.
  4. Cheng JM1, Valk SD, den Uil CA, van der Ent M, Lagrand WK, van de Sande M, van Domburg RT, Simoons ML. Usefulness of intra-aortic balloon pump counterpulsation in patients with cardiogenic shock from acute myocardial infarction. Am J Cardiol. 2009 Aug 1;104(3):327–32.
  5. Vidwan P1, Lee S, Rossi JS, Stouffer GA. Relation of platelet count to bleeding and vascular complications in patients undergoing coronary angiography. Am J Cardiol. 2010 May 1;105(9):1219–22
  6. Moscucci M, ed. Grossman & Baim’s cardiac catheterisation, angiography and intervention /ed. 8-th ed. Philadelphia, USA: Wolfwers Kluwer Health\ Lippincott Williams & Wilkins, 2013. 1168 p.
  7. Babunashvili AM, Ivanov VA, Biriukov SA. Endoprotezirovanie (stentirovanie) venechnykh arterii serdtsa [Endoprosthesis (stenting) of coronary arteries]. Moscow, RF: ASV; 2001. 699 p.
  8. Bokeriia LA, Shatalov KV, Svobodov AA. Sistemy vspomogatel'nogo i zamestitel'nogo krovoobrashcheniia [Auxiliary system and circulatory substitution]. Moscow, RF: 2000, NTsSSKh im AN Bakuleva. 2000. 200 p.
  9. Busch T1, Sirbu H, Zenker D, Dalichau H. Vascular complications related to intraaortic balloon counterpulsation: an analysis of ten years experience. Thorac Cardiovasc Surg. 1997 Apr;45(2):55–59.
  10. Natsional'nye rekomendatsii po vedeniiu patsientov s anevrizmami briushnoi aorty (rossiiskii soglasitel'nyi dokument) [National guidelines for treatment of patients with abdominal aortic aneurysms (Russian consensus document]. Moscow, RF. 2011.
  11. Bornac A, Upchurch GR, Velazquez OC. Aortic endovascular grafting. Grossman&Baim’s. Cardiac catheterisation, angiography and intervention. 8-the ed., Ed.M.Moscucci. Philadelphia, PA: Wolfwers Kluwer Health/ Lippincott Williams & Wilkins, 2013
  12. Soltoski PR, Karamanukian KhL, Salerno TA, Tikhonov PP. Khirmanov VN, red. Sekrety kardiokhirurgii [Some cardiac surgery secrets]. Moscow, RF: MEDpress-inform, 2005. 328 p.
  13. Seleznev VV, Mikutskii NS, Pyzhik RN, Shestakova LG, Bushkevich MI. Sosudistye oslozhneniia pri vnutriaortal'noi ballonnoi kontrpul'satsii (VABK) [Vascular complications of intra-aortic balloon counterpulsation (IABC)], Kardiologiia v Belarusi, 2011;(5):164–65.
  14. Allie DE, Hebert Ch J, Wolker CM. Establishing a peripheral vascular Center of Excellence. Endovascular Today. Feb 2005:41–44.
Address for correspondence:
220036, Respublika Belarus, g. Minsk, ul. R.Lyuksemburg, d. 110, RNPTs «Kardiologiya»,
e-mail: nickdoc@rambler.ru,
Mikutskiy Nikolay Stanislavovich
Information about the authors:
Selesnev V.V. PhD, an associate professor of the cardiac surgery chair of SEE “Belarusian Medical Academy of Postgraduate Education”.
Mikutski N.S. PhD, cardiac surgeon of the 1st cardiac surgery department of SE RSPC “Cardiology”.
Chernoglaz P.F. An endovascular surgeon of the endovascular surgery department of SE RSPC “Cardiology”.
Shestakova L.G. MD, a head of the extracorporeal blood circulation department of SE RSPC “Cardiology”.
Zhigalcovich A.S. PhD, a head of the 1st cardiac surgery department of SE RSPC “Cardiology”.
Ostrovsky Yu.P. Corresponding Member of NAS, MD, professor, a head of the cardiac surgery chair of SEE “Belarusian Medical Academy of Postgraduate Education”, Chief Freelance cardiologist of MOH of RB.
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