The OBJECTIVE was to determine the impact of timing of coronary artery bypass grafting in patients with acute coronary syndromes (ACS) on treatment outcomes, such as 30-day mortality and the incidence of perioperative complications.METHODS AND MATERIALS. Completed cases of treatment from 2014 to 2022 were analyzed among 264 patients (193 men and 71 women) (mean age 64.5±9.2 years) with various forms of ACS who underwent myocardial revascularization with coronary artery bypass grafting. Thirty-four patients presented with STEMI, 96 with NSTEMI, and 134 with unstable angina. Of these, 32 patients underwent emergency surgery (within 24 hours of symptom onset). Urgent surgery (more than 24 hours) was performed in 232 cases. The follow-up period was 30 days. The incidence of 30-day mortality among patients, as well as the incidence of perioperative complications such as acute myocardial infarction, stroke, and acute renal failure, were assessed.RESULTS. 30-day mortality and perioperative complications among patients undergoing emergency surgery were two or more times higher. However, no statistically significant difference in the odds of developing or in the incidence of death, postoperative acute renal failure, or stroke was found in either the overall cohort or among patients with different forms of ACS, even those as severe as those with STEMI (P>0.05). The risk of developing postoperative acute myocardial infarction was significantly higher in emergency surgeries (P<0.05).CONCLUSION. CABG is an option for patients with ACS who are not candidates for PCI. However, despite the absence of a statistically significant difference, there is a statistical trend indicating that performing surgery on an emergency basis is associated with an increased incidence of mortality and perioperative stroke and acute renal failure in patients with STEMI and unstable angina.
INTRODUCTION. Congenital defects of the bronchopulmonary system (CDBPS) occupy a significant place in the structure of perinatal pathology. According to the literature, their incidence is 1 per 10,000–35,000 live births. Cystic forms of bronchopulmonary malformations (CBPM) constitute a significant portion of CDBPS.METHODS AND MATERIALS. A retrospective analysis was performed in 106 children with CBPM treated at the clinics of Tashkent State Medical University from 2006 to 2024. Patients were divided into a comparison group (n=52, 2006–2017, conventional approach) and a study group (n=54, 2018–2024, extended diagnostics and video-assisted thoracoscopy). Postoperative complications were graded according to the Clavien – Dindo classification. Longterm outcomes were assessed in 92 patients over 6 months to 5 years.RESULTS. Surgery was performed in 92 (86.8 %) children. Postoperative complications (Clavien – Dindo I–V) occurred in 22 (23.9 %) patients: 8 patients (17.0 %) were in the study group and 14 patients (31.1 %) were in the comparison group (p<0.05). Grade III–V complications were 10.6 % vs 15.6 %, respectively. Mortality was 1.1 % (n=1). Good longterm outcomes were achieved in 54.3 %. The mean total length of hospital stay in the study group was 14.2±3.8 days versus 21.4±5.6 days in the comparison group (p<0.05). The rate of unsatisfactory results in the study group decreased from 20.5 % to 9.4 % (p<0.05).CONCLUSION. Optimization of diagnostic and surgical strategies, including prenatal screening, MSCT, and videoassisted thoracoscopic surgery, significantly reduces the overall rate of complications and improves longterm treatment outcomes of CBPM in children.
OBJECTIVE. To evaluate the effectiveness and safety of transseptal access (transseptal puncture, TSP) for left-sided catheter interventions and left atrial appendage occluder implantation, and to compare single- versus double-puncture techniques. MATERIALS AND METHODS. We retrospectively analyzed procedures performed in 2013–2023. Overall, 775 TSPs were performed: group A (n=710) – double TSP under fluoroscopy using an in-house technique; group B (n=38) – single TSP guided by transesophageal or intracardiac echocardiography; group C (n=27) – single TSP under fluoroscopy for high-density mapping-guided ablation. Statistical significance was set at p<0.05.RESULTS. TSP success rate was 100 % across groups. Single puncture reduced puncture time. Early complications (hemopericardium/tamponade, cerebrovascular events, access-site hematoma) were infrequent and did not differ between groups.CONCLUSION. TSP is an effective and safe method for left heart catheterization. Adjunct imaging (TEE/ICE) may improve safety in challenging anatomy.
An outstanding pediatric surgeon and traumatologist-orthopedist, scientist, teacher and organizer of pediatric medical services, one of the founders of pediatric surgery in the USSR, the creator of a large national school of pediatric surgeons, traumatologists and orthopedists, Corresponding Member of the USSR Academy of Medical Sciences (1956), Honored Scientist of the RSFSR (1956), Professor (1942) Sergei Dmitrievich Ternovsky was born on September 8 (September 20, new style), 1896, in the village of Zyuzdino, Glazovsky Uyezd, Vyatka Governorate, into a peasant family. After graduating from the Moscow Gymnasium with a silver medal, Sergei Ternovsky entered the Faculty of Medicine of Moscow State University. Immediately after graduation, the young doctor was drafted into the Red Army and served in various medical positions in the 10th Army of the Southern Front. After demobilization in February 1924, S. D. Ternovsky began his residency at the Hospital Surgery Clinic of Moscow University, headed by Professor A.V. Martynov. In 1927, Sergei Dmitrievich was elected to the position of resident in the surgical department of the City ModelChildren’s Clinical Hospital № 1. From 1940 to 1946, he served as head of the surgical department of the Central Pediatric Research Institute of the Ministry of Health of the RSFSR. In 1943, the Department of Pediatric Surgery and Orthopedics was organized at the 2nd Moscow State Medical Institute and on the basis of the surgical department of City Children’s Clinical Hospital № 1. Professor S. D. Ternovsky was elected head of the department. He headed this department until the end of his life. In 1952, on his initiative and with his direct participation, the Pediatric Surgery Section was established at the Surgical Society of Moscow and the Moscow Region, and Sergei Dmitrievich served as its permanent chairman. During the 17 years that S. D. Ternovsky headed the Pediatric Surgery and Orthopedics Department at the 2nd Moscow Medical Institute named after N. I. Pirogov, 21 candidate’s and 3 doctoral dissertations were defended. Department staff published approximately 450 scientific papers. The department and clinic truly became the educational and methodological center of pediatric surgery and orthopedics in the Soviet Union. Hundreds of pediatric surgeons and orthopedists from all corners of the country attended advanced training courses. Many of Sergei Dmitrievich’s students became heads of major trauma and orthopedic institutions (the N. N. Priorov Central Institute of Traumatology and Orthopedics, the Central Institute of Prosthetics and Prosthetics, the G. I. Turner Children’s Orthopedic Institute, and the Russian Institute of Pediatrics and Pediatric Surgery), as well as traumatology and orthopedics departments at medical institutes. S. D. Ternovsky died on November 19, 1960, and was buried in Moscow at the Novodevichy Cemetery.
We demonstrate a clinical case of successful total esophageal demucoization in a 69-year-old patient in order to eliminate salivary esophageal fistula and pleural empyema after laparoscopic proximal subtotal gastric resection for early gastric cancer complicated by the failure of esophageal anastomosis, followed by delayed coloesophagoplasty.
