Medical error
Medical error – it is a reality that must be avoided!
Medical error is an inevitability that will overtake everyone who uses medical care. Medical personnel, by means of the state-of-the-art techniques and spurred by business, intervene in the patient’s body. And the more aggressive this intervention is, the higher is the cost of an error.
Difficult cases. How did we manage?
Echocardiography in cardiology and cardiac surgery
Speckle tracking analysis to determine global longitudinal deformity (GLS) in the management of a patient with heart failure in the long term after CABG.
Coronary artery bypass grafting (CABG)
Minimally invasive direct coronary artery bypass grafting (MIDCABG)
The main task is to perform the operation without incising the sternum. This will allow to avoid osteomyelitis of the sternum in future, the dehiscence of wire sutures in case of its “inconsistency” and will preserve the “frame” of the chest, which is extremely important for full value breathing in the postoperative period. Full value breathing will avoid the development of atelectasis in the lung, pneumonia, postcardiotomy syndrome, manifested by inflammation of the pleura and pericardium with hyperproduction of exudate.
Dual inflow, total-arterial, anaortic, off-pump coronary artery bypass grafting: how to do it
Off-pump CABG
Two times reduced heparin dosage leading to lower risk of bleeding.
Five-year Outcomes after Off-pump or On-pump Coronary Artery Bypass Grafting
No-touch aorta technique
Reduced chance of the embolic stroke due to the damage to plaques on the aortic wall.
Current Practice of State-of-the-Art Surgical Coronary Revascularization
Total arterial myocardial revascularization
A patient who has used autoarteries for coronary artery bypass grafting will live longer than a patient with used veins and, moreover, a patient with stented arteries. But we can observe this only after a 10-year period after the operation.
Radialis artery harvesting – how I do it
The 10 Commandments for Multiarterial Grafting
How I deploy arterial grafts (by David P. Taggart)
Total Arterial Revascularization: The Case for Radial Artery Conduit
Effect of Bilateral Internal Mammary Artery Grafts on Long-Term Survival
Chronic ischemic heart disease
Why bypass grafting is better than stenting even in the old version CABG?:
Compliance With Guideline-Directed Medical Therapy in Contemporary Coronary Revascularization Trials
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization in the FREEDOM Trial
Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease
PCI vs CABG in Left Main Disease — The Surgeons and Statisticians Are Right
10-year follow-up of the multicentre randomised controlled SYNTAX trial
Long-term study finds QoL improvements in CABG patients despite complications
Controversy in PCI (coronary stentings)
The intracoronary stenting epidemic is driven by pressure from the stent manufacturer’s market, which has an annual turnover of over $6 billion per year. As for efficiency … judge for yourself.
AHA 2019: ISCHEMIA Trial a Moment of Truth for PCI?
ORBITA: Sham Comparison Casts Doubt on PCI for Stable Angina
Acute heart failure
Acute heart failure is a life-threatening condition that requires immediate decision-making and is accompanied by active interventions in the human body. Acute coronary syndrome (ACS), acute myocarditis, pulmonary embolism (right ventricular failure), acute regurgitation on the aortic and mitral valves are the main causes of acute heart failure.
Vascular surgery
Carotid artery atherosclerosis
Atherosclerosis of the carotid artery is the cause of every third ischemic disorder of cerebral circulation (stroke).
Today, open surgery is always a priority for stenting (see figure 3)
Valve surgery
Minimally invasive aortic valve surgery
Minimally invasive surgery of the aortic valve can be of three types: percutaneous puncture valve implantation (TAVI), implantation through minithoracotomy or through ministernotomy. TAVI is the least traumatic, because with this valve implantation, there is no need for cardiac arrest and any surgical access.
Minimally invasive mitral valve surgery
Mitral valve repair from minimally invasive approach is a whole specialty within cardiac surgery, video life hacks for those who are interested.
The Evolution of Repair Techniques
Principles of Degenerative Mitral Valve Repair
Mitral Valve Repair with Chordal Replacement using Chord-X Pre-Measured Loops
Mitral Valve Repair in Barlow’s Disease Using PTFE Neochords and Annuloplasty: The Bending Plasty
Mitral Valve Surgical Management: Repair, Replace or Do Nothing?
Minimally invasive mitral valve repair – tips for safely negotiating the learning curve.
Minimally Invasive Totally Endoscopic Beating Mitral Valve Repair
Robotically-Assisted Mitral Valve Commissuroplasty: An Easy Fix for a Complex Jet
Optimal surgical mitral valve repair in Barlow’s disease
Robotic Totally Endoscopic Repair of Barlow’s Mitral Valve (balloon occluder)
Dealing With Barlow’s Valve Disease and Syndrome
Minimally Invasive Mitral Valve Repair of Bi-leaflet Prolapse: How Do I Do It?
Minimally invasive concomitant aortic and mitral valve surgery: the “Miami Method”
Hybrid surgery
Aortic arch reconstruction without circulatory arrest
If the patient has developed aortic dissection, affecting only the region of the arch and the descending aorta, then hybrid surgery may be the method of choice: moving the brachiocephalic arteries into the ascending aorta using the bald arch technique, followed by placing a stentgraft in the dissection zone to eliminate the zone of entry into the dissection and remodeling of the thoracic aorta.
Hybrid coronary revascularization
There’s intraoperative ultrasound of the heart in 100% of cases (remote monitoring of intracardiac hemodynamics).
Minimally invasive approach is utilized for both multivessel bypass grafting and hybrid surgery (stent + LIMA to LAD).
Blood is being preserved by the Cell Saver device (donor blood is not required).
Nerve block anesthesia. There are not narcotic drugs both intraoperatively and in the postoperative period. There’s no pain (full breathing) – no pneumonia.
Standardizing definitions for hybrid coronary revascularization