Heart transplant patients are at an increased risk of COVID-19 infection adverse outcomes because of underlying immunosuppression and concomitant comorbidities. To date, all large-scale randomized controlled trials for various COVID-19 vaccines have excluded solid organ transplant recipients. Therefore, the efficacy and safety of coronavirus infection prevention using COVID-19 vaccines in transplant heart patients has not been sufficiently studied. In this research, the evaluation of virus-specific immunological reactions after vaccination (double Vero Cell vaccination and Sputnik Light booster vaccination) in heart transplant patients has been carried out. In vaccinated heart transplant individuals who did not have a history of COVID-19, starting from 4–6 months after the 2nd dose of the vaccine, an increase in antibodies to S protein level of was observed, while maintaining statistically significant differences for 9–12 months after vaccination (regardless of whether with or without booster vaccination). However, the concentration of antibodies remained low, and 37% of patients detected no antibodies. In vaccinated heart transplant individuals following the previous COVID-19 infection, as compared to seronegative patients, post-vaccination immunity is accompanied by maintaining a high level of virus-specific IgG antibodies to the S protein of the SARS-CoV-2 virus in the dynamics of the post-vaccination period with a statistically significant increase of these antibodies by 9–12 months after booster vaccination. The specific cellular response (according to the assessment of CD3⁺154⁺ and CD3⁺IFNγ⁺ TNFα⁺ cells) to the S protein of the SARS-CoV-2 virus remained low throughout the entire follow-up period, was recorded in 5–40% of heart transplant patients and statistically significant changes in the number of spikereactive lymphocytes were observed in patients with a history of COVID-19 by 4–6 months after administration of the 2nd dose of the vaccine. This, together with the results of the assessment of the humoral response, indicates a more pronounced post-vaccination immunity in patients with a hybrid immunity. While developing a methodology for assessing the risk and benefit of a vaccination strategy for individual heart transplant patients, clinical efficacy, ongoing monitoring of rare serious adverse events, and data on vaccine immunogenicity should be taken into account.

This article describes clinical observation over a patient with a biventricular form of arrhythmogenic cardiomyopathy associated with a mutation in DSG2 gene. The morphological realization of this mutation is associated with fibrous-fat replacement of the myocardium of both ventricles of the heart, which is clinically manifested by the development of life-threatening ventricular arrhythmias and a high risk of biventricular heart failure with a tendency to a progressive decrease in myocardial contractility. The affect on young people of working age, hereditary determinism and an unfavorable prognosis of survival actualizes the importance of diagnostic alertness in the examination of young patients with a clinical picture including ventricular arrhythmias, presyncope, syncope conditions and sudden cardiac death. The main issues of diagnosis, criteria for diagnosis in accordance with the Padua criteria (2020), current principles of treatment and prevention of sudden cardiac death are considered.

Objective: to assess the clinical, hemodynamic, laboratory efficiency and survival potential of patients having undergone plastic repair of atrioventricular valves. Material and methods . Patients with functional class (FC) III and IV chronic heart failure (CHF) according to NYHA (New York Heart Association - Functional Classification), who had undergone plastic repair of atrioventricular valves, were included in the study. Results. The study has found that the return of mitral regurgitation after mitral valve repair in patients is associated with their age, 4 degree and volume of mitral regurgitation of more than 42 ml before the surgery. Conclusion . The results obtained during the study allow to draw a conclusion that surgical reconstruction of atrioventricular valves contributes to a longer life expectancy and enhances quality of life of patients. Furthermore, it makes it possible to postpone heart transplantation and thus may be regarded as «a surgical bridge» to othotopic heart transplantation.

Objective: to assess the clinical, hemodynamic, laboratory efficiency and survival potential of patients having undergone plastic repair of atrioventricular valves. Material and methods . Patients with functional class (FC) III and IV chronic heart failure (CHF) according to NYHA (New York Heart Association - Functional Classification), who had undergone plastic repair of atrioventricular valves, were included in the study. Results. The study has found that the return of mitral regurgitation after mitral valve repair in patients is associated with their age, 4 degree and volume of mitral regurgitation of more than 42 ml before the surgery. Conclusion . The results obtained during the study allow to draw a conclusion that surgical reconstruction of atrioventricular valves contributes to a longer life expectancy and enhances quality of life of patients. Furthermore, it makes it possible to postpone heart transplantation and thus may be regarded as «a surgical bridge» to othotopic heart transplantation.