Background. Endovascular occlusion of the left atrial appendage (LAA) using the Watchman device may be considered an adequate alternative to oral anticoagulant (OAC) administration in high-risk patients.Objective. To describe our experience with Watchman endovascular occlusion of the left atrial appendage in a city hospital setting in terms of feasibility and safety, as well as assess the short-term efficacy of this procedure.Design and methods. The study included patients who underwent implantation of the Watchman occlusion device from January 2016 to November 2020. The effectiveness of the procedure was defined as the ability to implant the Watchman without maintaining residual current, safety was defined as the occurrence of nosocomial and 45-day events including stroke, pericardial effusion, major bleeding, and device migration.Results. The study included 22 patients: 10 men and 12 women, who underwent implantation of the Watchman occluding device in the LAA. The indication for implantation was a history of gastrointestinal bleeding in 15 patients, cerebral hemorrhage in 3 patients and low compliance to therapy in 4 patients. The success rate of the procedure was 95.7 %. According to control transesophageal echocardiography, after 45 days LAA was excluded from the bloodstream in 21 of 22 patients.Conclusion. Despite the higher complication rate of occlusion of the LAA compared to drug treatment, the overall mortality from any cause in patients with the implanted Watchman was lower.

Objective: to analyze the parameters of 2D and 3D transthoracic echocardiography (TEE) with speckle-tracking technology in young athletes. Materials and methods: 79 athletes (52 male, 27 female, median age 20,5±3,7 years) undergone prospective analysis. Participants were divided into groups by level of training (group A-professionals and group B-amateurs) and by gender (group 1-men and group 2-women). Athletes underwent 12-lead ECG, 2D TTE and 3D TTE with a speckle-tracking. The evaluation of LV function was performed using the speckle-tracking method with the assessment of LV longitudinal strain in the Automated Function Imaging mode. Results: significant differences in LDV (р

The modern doctrine of treating ischemic heart disease (IHD) is aimed to choose a method, which maximizes the effectiveness and safety for patients. Currently there are three approaches for treatment of stable IHD: optimal medical therapy, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Each approach has own indications and contraindications, based on international recommendations. Separate controversial group of patients are the elderly and senile patients. Limited physical activity, comorbidities, high complications risk in post-PCI double antiplatelet therapy and after CABG, requires strongly individualized approach and proved treatment method. Surgery is possible only after myocardial ischemia is proved by noninvasive imaging methods, assessment of fractional flow reserve (FFR) or its alternative – instant wave-free ratio (iFR) during the coronary angiography. Determination of hemodynamically significant stenosis helps interventional cardiologists to avoid unreasonable revascularization and PCI-related complications.