Coronary heart disease (CHD) is associated with oxidative stress (OS), in which this balance is disrupted, and the production of ROS outweighs their elimination. The oxidative reaction leads to impaired cell function and may increase the likelihood of complications during or after coronary artery bypass surgery (CABG). In pathophysiological conditions associated with OS, there is a general increase in the need for glutathione in antioxidant reactions, conjugation reactions and reduction of protein disulfides. Data on the effect of CABG on plasma aminothiols are incomplete and contradictory.The plasma pool of aminothiols, on the one hand, has a significant effect on the metabolism of glutathione in the tissues of blood vessels and the heart, and on the other hand, may reflect its disorders. CABG, in turn, can be considered as a procedure that triggers stress and adaptive mechanisms that can have a significant effect on the metabolism of aminothiols. However, to date, data on this effect of CABG are fragmentary. To understand the processes occurring in the aminothiol system in coronary heart disease and CABG, it is important to detect not only shifts in the concentrations of these markers, but also.

The end-stage stage of chronic diseases of solid organs is rather significant in the structure of morbidity and mortality among patients worldwide. To date, there are more than six million patients in this status worldwide. Heart, liver and kidney transplantation is the gold standard of treatment for these patients. The number of transplants is growing every year.At the end of 2019, the world faced a new type of viral infection – SARS-CoV-2 – a highly contagious systemic respiratory disease transmitted by airborne droplets, which in three months led to a pandemic and killed hundreds of thousands of people. The pandemic has made adjustments to the structure of planned medical care. The number of planned operations has decreased significantly, and the number of the infection-associated complications has increased.Patients with end-stage chronic diseases initially have weakened immunity and represent the category most susceptible to the infection. At the moment, the question of patient management tactics remains open. There is no consensus on the patient management tactics before surgery and in the posttransplantation period for patients at the end-stage chronic disease of different organs. This topic requires further study and the development of treatment algorithms for such patients.

To increase the yield of living cells and their survival, studies were carried out to optimize the method for isolating cardiomyocytes from biopsy specimens excised from the right atrial appendages. It was found that creatine, blebbistatin, and taurine are necessary components of the buffer solution during cardiomyocyte isolation, and that composition of the solutions is a more important factor than their oxygenation.

КЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ ХИРУРГИЯ■ ФУНДАМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ И МЕЖДИСЦИПЛИНАРНЫЕ ТЕХНОЛОГИИ Актуальность.Кардиоплегия играет важную роль в кардиохирургии, обеспечивая защиту миокарда и возможность выполнения операции.При этом одной из наиболее распространенных форм нарушения ритма сердца после операций с использованием кардиоплегических растворов у больных с ишемической болезнью сердца является мерцательная аритмия.Патогенез этого осложнения до конца не изучен, однако известна его многофакторность.Одними из наиболее значимых являются электролитные нарушения, связанные с нарушением работы ионных каналов кардиомиоцитов после введения кардиоплегических растворов

Heart failure (HF) is a common condition, and its overall prevalence is constantly growing. HF ultimately progresses to end-stage disease that is refractory to optimal medical therapy and requires implantable devices or heart transplant. In recent years, cardiac resynchronization therapy (CRT) has been generally accepted in patients with NYHA class III or IV, reduced left ventricular ejection fraction (less than 35%), and the wide QRS complex (>120 msec). CRT improves the efficacy of heart ventricle function and, as a result, physical performance and quality of life. Reverse cardiac remodeling occurs at a pathophysiological level that improves systolic function. Patients with end-stage HF who are on the heart transplant list are a specific group in whom CRT is considered a “bridge” to surgery. This review paper discusses state-of-the-art, advances, and unresolved issues in this area. KEYWORDS: cardiac resynchronization therapy, heart failure, left ventricular remodeling, ejection fraction, heart transplant. FOR CITATION: Shumakov D.V., Zybin D.I., Popov M.A. et al. Resynchronization therapy in end-stage heart failure. Russian Medical Inquiry. 2021;5(4):206–211 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-206-211.

Rationale. Secondary, or functional, mitral regurgitation is the most common complication of heart failure. Dysfunction of one or more mitral valve structures occurs in 39–74% of patients thus complicating the course of the disease and significantly worsening the prognosis in patients with left ventricle dilatation. An unfavorable prognosis in patients with the development of mitral regurgitation is conditioned by the progressive changes that form a vicious circle: the continuing volume overload and dilatation of the left ventricle cause its remodeling, leading to further dilatation of the mitral valve annulus. Dysfunctions of the papillary muscles lead to the increased tension of the left ventricle wall and increased mitral regurgitation. Clinically, this process is manifested by the congestive heart failure progression and worsened prognosis of the further course, which in the future may lead to considering the inclusion of this patient group on the waiting list for heart transplantation.Purpose. The purpose of this article is to review the role of surgical management in patients with heart failure complicated by mitral regurgitation.Conclusions. The main principles of the treatment for functional mitral regurgitation include the reverse left ventricular remodeling and mitral valve repair or replacement surgery which lead to an improved quality of life, the transition of patients to a lower functional class, reduced hospital admission rates, and also to a regression or slower progression of the heart failure and to an improved survival.

Трансплантация сердца является «золотым стандартом» лечения терминальной сердечной недостаточности при неэффективности оптимальной медикаментозной терапии и невозможности реконструктивной хирургии. Трансплантация сердца увеличивает выживаемость пациентов с рефрактерной стадией сердечной недостаточности, улучшает качество жизни больных и позволяет большинству из них вернуться к активной жизни. По последним опубликованным данным Международного регистра, за 2017 г. было выполнено более 5000 трансплантаций сердца. Годовая, 5- и 10-летняя выживаемость после трансплантации сердца составляет 88, 74 и 55%, соответственно. В системе здравоохранения Московской области программа трансплантации сердца стартовала в МОНИКИ им. М.Ф. Владимирского в 2019 г. После завершения всех организационных и логистических процедур был начат подбор реципиентов с целью формирования листа ожидания. В статье представлен первый клинический опыт трансплантации сердца в системе здравоохранения Московской области.

Despite the widespread use of mechanical circulatory support systems, modern optimal drug therapy and various interventional methods of heart transplantation remain the "gold standard" for the treatment of end-stage heart failure patients.At the same time the required number of heart transplants is significantly increasing due to the progressively increasing number of patients needing transplants and the actual donor pool. In recent years there has been a trend towards the increase in the number of recipients and the decrease in the number of donor organs. However, the use of donor hearts with pathological changes, including left ventricular myocardial hypertrophy, remains a controversial topic. It is believed that the use of expanded criteria significantly increases the risk of graft failure in the post-transplant period and leads to deterioration of immediate and long-term results. This work aimed to analyze the data on using donor hearts with left ventricular myocardial hypertrophy for allotransplantation.Authors declare no conflict of interest.

Introduction. One of the most complex and rapidly developing areas in cardiovascular surgery is aortic surgery. In recent years, surgery for combined aortic pathology, as well as reconstructive surgery of the aortic root and aortic valve, has been actively developing. Today, with aneurysm of the ascending aorta with aortic insufficiency and the absence of morphological changes in the aortic valve flaps, they try to resort to various options of valve-preserving operations. The progress achieved in endovascular treatment of aortic pathology has reduced operational mortality and improved the long-term results of treatment of abdominal aortic aneurysms. Clinical characteristics of the patient. In the described clinical case, taking into account the general severity of the patient's condition and the high risks of simultaneous surgery, the tactics of two-stage surgical treatment were chosen. The first stage is prosthetics of the ascending aorta with the preservation of the native valve, the second stage is endovascular treatment of the infrarenal aorta. Conclusion. This work demonstrates the successful clinical experience of a multidisciplinary approach to the two-stage treatment of a patient with aneurysm of the root and ascending aorta with aortic valve insufficiency and aneurysm of the infrarenal aorta.