THE SEPTAL REDUCTION SEVERITY AND OUTCOMES AFTER ALCOHOL SEPTAL ABLATION IN PATIENTS WITH OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY E. A. Shloydo, M. G. Kashtanov, K. V. Popov, A. S. Sergeev, D. S. Maznev, S. D. Chernyshev Grekov S Bulletin of Surgery, 2026 INTRODUCTION . This study examines the impact of the degree of interventricular septum reduction (<5 mm and ≥5 mm) on outcomes following alcohol septal ablation. METHODS AND MATERIALS . Data from 597 patients with obstructive hypertrophic cardiomyopathy who underwent alcohol septal ablation were analysed. Patients were divided into two groups: septal reduction <5 mm (329 patients); septal reduction ≥5 mm (268 patients). To correct the imbalance between the groups, the propensity score matching method was used. Outcomes were studied in both matched and unmatched cohorts. RESULTS . In the long-term follow-up period, 63 deaths were recorded. In the group with ≥5 mm reduction, gradients of the left ventricular outflow tract were lower (p<0.0001). Residual obstruction was more frequently observed in the <5 mm reduction group: unmatched cohort: 87 (26 %) vs. 37 (14 %), p<0.0001; matched cohort: 66 (33 %) vs. 21 (10 %), p<0.0001. Long-term survival was statistically significantly lower in the<5 mm reduction group: HR 0.47 (95 % CI: 0.24–0.89), p=0.019. CONCLUSION . Septal reduction of less than 5 mm following alcohol septal ablation is associated with: higher gradients of the left ventricular outflow tract; a higher incidence of residual obstruction; worse long-term survival.
EFFICIENCY OF HYBRID SURGICAL TREATMENT OF THE AORTIC ARCH AND DESCENDING THORACIC AORTA ANEURYSM V. V. Shlomin, P. B. Bondarenko, E. A. Shloydo, P. D. Puzdriak, Yu. P. Didenko, I. R. Uzhakhov, K. A. Petrova, A. V. Gusinskiy, A. A. Erofeev, K. R. Akimova Grekov S Bulletin of Surgery, 2022 OBJECTIVE. Assessment of the mid-term results after various types of debranching in hybrid surgery of the aortic arch and descending thoracic aorta.METHODS AND MATERIALS. 47 patients with various pathologies of the aortic arch and descending thoracic aorta were operated on. Six of them suffered from type IIIa dissection and 26 from type IIIb dissection according to DeBakey classification, 15 patients had true aortic aneurysms. The following interventions were performed: total aortic arch debranching (n=5), cross subclavian-subclavian-left-common carotid (n=14) or cross carotid-carotid-subclavian bypass (n=7); subclavian-carotid transposition or bypass (n=12); Chimney technique for the aortic arch aneurysm (n=8); in situ fenestration of the endoprosthesis (n=1). Elective surgery was performed in 32 patients, emergency in 15.RESULTS. Technical success achieved in 100 %. The overall hospital mortality rate was 10.6 % (n=5), elective surgery mortality rate was 9.3 % (n=3), in emergency cases - 13.3 % (n=2). Causes of mortality: stroke (n=1), multiple organ failure after prosthetic ascending aorta due to retrograde dissection after stent graft implantation (n=1), pneumonia (n=1), acute myocardial infarction (n=1), profuse bleeding (n=1). Cumulative survival rate was 87.5 % over 5 years, freedom from reinterventions - 89.1 %. During the first year of observation, 3 patients underwent stent graft replacement of the descending thoracic aorta due to formation of a dissection below the primary stent graft (n=1), open prosthesis of the ascending aorta due to it retrograde dissection (n=1), endofixation of the stent graft with embolization of the false lumen (n=1).CONCLUSION. Hybrid surgery on the aortic arch and the descending thoracic aorta is safe and effective treatment. Regular follow-up and timely treatment of complications in the long term after hybrid or endovascular interventions are necessary to improve long-term results.
Redo surgery after thoracic endovascular aortic repair V.V. Shlomin, P.B. Bondarenko, E.A. Shloydo, P.D. Puzdryak, I.R. Uzhakhov, A.V. Gusinsky, N.Yu. Grebenkina, I.G. Drozhzhin Kardiologiya I Serdechno Sosudistaya Khirurgiya, 2020 <h3>ЦЕЛЬ</h3> Изучить отдаленные осложнения после эндопротезирования грудной аорты и их хирургическое лечение. <h3>МАТЕРИАЛ И МЕТОДЫ</h3> Представлено 10 случаев повторного лечения после эндопротезирования грудной аорты. Средний возраст пациентов составил 66±11 лет. Период между первичным эндопротезированием и повторной операцией — 22±15 мес. Причинами повторного хирургического и эндоваскулярного лечения явились рост ложного канала нисходящей грудной аорты на фоне эндолика Ib типа (<i>n</i>=1), формирование торакоабдоминальной аневризмы (<i>n</i>=1), формирование аневризмы нисходящей грудной аорты ниже стент-графта (<i>n</i>=1), расхождение модулей эндопротезов в нисходящей грудной аорте (<i>n</i>=1), расслоение по дистальному краю стент-графта (<i>n</i>=1), ретроградное расслоение восходящей аорты (<i>n</i>=1), миграция стент-графта с развитием эндолика I типа и продолжением легочного кровотечения (<i>n</i>=2), вторичная аорто-пищеводная фистула (<i>n</i>=1), эндолик Ia типа (<i>n</i>=1). <h3>РЕЗУЛЬТАТЫ</h3> Выполнено повторное эндопротезирование 5 пациентам (50%), открытая операция — 5 (50%) больным. Летальный исход отмечен у 1 пациента (10%) на фоне синдрома полиорганной недостаточности на 5-е сутки после ликвидации аорто-пищеводной фистулы. <h3>ВЫВОД</h3> Повторные операции после эндопротезирования грудной аорты могут быть безопасно и эффективно выполнены с высоким уровнем выживаемости.
[Technical aspects of surgical treatment of patients with the aneurysm of the aortic ascending segment]. Vestnik Khirurgii Imeni I I Grekova, 2013
[Changes of intracardiac hemodynamics in plasty of the mitral valve with a synthetic band, early period of observation]. Vestnik Khirurgii Imeni I I Grekova, 2011
