Vol 13, No 1 (2022)

Aim. To compare the results of mitral valve replacement with the full-flow mechanical valve «MedInzh-ST» and the classical prosthesis «MedInzh-2», to learn the structural and functional parameters of the heart depending from the prosthesis in the long-tern period.

Material and methods. From 2015 to February 2020 years an the basis of the cardio-surgical department of the «Regional clinical Hospital» 116 patients, in order to correct defects, were underwent mitral prosthetics with «MedInzh» valves. Of these 55 patients received a new full-flow valve «MedInzh-ST». 61 patients – a classical «MedInzh-2». Before surgery and in the long-term period all patients were underwent transthoracic echocardiography with using expert-class devices. In the long-tern postoperative period 34 patients were underwent echocardiographic research after implantation full-flow valves and 40 patients after prosthetics of classical prosthesis.

Results. The choice of the prosthesis model did not affect the incidence of postoperative complications and the rate of hospital mortality. In all cause of death is not associated with impaired function of the prosthesis. All patients before the discharge from hospital were fixed the positive effect from surgical treatment. In the long-term postoperative period between patients after implantation of full-flow valves, the cases of prosthetic platelets were not registered. One patient was diagnosed with prosthetic thrombosis after implantation of a classical prosthesis, which required further reprosthetics. There were no signs of prosthetic endocarditis and paraprosthetic fistula in both groups. There were no significant differences in the structural and geometric parameters of the heart in all patients.

Conclusion. Analysis of the functional characteristics of the new full-flow valve «MedInzh-ST» in the long-term period allows us to conclude that the new valve model meets modern requirements for efficiency and safety.

The article presents the current understanding of the problem of radiation therapy (RT)-induced heart diseases. The paper is based on a clinical case of restrictive cardiomyopathy in a female previously cured of Hodgkin's lymphoma with RT. The importance of using modern imaging technologies aimed at verifying pathomorphological changes in the myocardium that cause the development of heart failure with preserved left ventricular ejection fraction is reflected. The given clinical case shows the combination of visceral complications arising in the long term after RT in oncohematological patients.

Currently there is a rapid progress in the new technologies development that expand the possibilities of home cardiac rehabilitation and telerehabilitation. It seems relevant to use wearable devices to monitor hemodynamic parameters, electrical activity of the heart, physical activity of patients in cardiac rehabilitation. This is especially important when monitoring the condition of elderly people and patients with comorbid conditions. The perspectives of sensors integration for assessment of not only hemodynamic parameters, but also the assessment of sensors that allow to monitor some metabolic indicators, human behavior are extremely important for cardiac patients. The use of digital technologies will significantly speed up the process of integrating cardiac rehabilitation into the general health care system. This will also allow to assess the need of high-quality medical care for the maximum of patients to whom it is indicated.

The problem of the mitral valve (MV) dysfunction, both in isolation and combination forms with other anomalies and lesions of connective tissue structures, is very current. Mitral insufficiency (MI) in case of the connective tissue dysplasia is the most common valvular pathology, accompanied by different degrees of severity. Nowadays the progradient development of functional and clinical symptoms of this disease has been studied, the questions of epidemiology, diagnosis and prognosis have been clarified and reconsidered. There are important issues of correct diagnosis, time and method of treatment, the decision of usage a valve-repair or valve prosthesis in the certain clinical situation. All these practical algorithm steps depend on the clinical and surgical experience of the medical institutions which work with this pathology. The purpose of this article is to expand the knowledge of practical doctors in the issue of MI in case of connective tissue dysplasia, including the questions from the model of the MV structure to modern methods of treatment which are described in the contemporary literature.

It has been proven that in patients with heart failure (HF), there is an increased level of adrenomedullin (ADM) in plasma. Biomarker indices correlate with the severity of hemodynamic dysfunction, as well as with neurohumoral indices, which are activated depending on the severity of congestive circulatory failure. In addition, the expression of the ADM gene in the heart and kidneys is increased in experimental and clinical HF. A small number of studies have examined the effect of ADM infusion. These studies have generally shown that hormone infusion has beneficial hemodynamic effects and promotes the maintenance/improvement of renal function, but most of the studies have been short-lived. The available results suggest that increasing ADM levels reduce the negative effects of vasoconstriction and sodium retention. A better understanding of the role of a biological marker in congestive circulatory failure may lead to the development of drugs that target ADM receptors.