Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2018; 15 (4): 237-299 ➤ Отбор пациентов старше 75 лет для открытого сочетанного вмешательства и конечные точки оценки результата протезирования аортального клапана с коронарным шунтированием: размышления на примере клинического случая

Selection of patients over 75 years old for open combined surgery and endpointsof assessment of outcomes of aortic valve replacement with coronary arteriesbypass grafting: reflections on a clinical case

Authors: T.G. Nikitina, R.M. Muratov, A.A. Fadeev, N.Z. Tsitlidze, L.A. Glushko

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-4-277-285

UDC: 616.126.52-089.844:616.132.2-089.86]-053.9-089-059

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (4): 277-285

Quote as: Nikitina T.G., Muratov R.M., Fadeev A.A., Tsitlidze N.Z., Glushko L.A. Selection of patients over 75 years old for open combined surgery and endpoints of assessment of outcomes of aortic valve replacement with coronary arteries bypass grafting: reflections on a clinical case. Clinical Physiology of Circulation. 2018; 15 (4): 277–85 (in Russ.). DOI: 10.24022/1814-6910-2018-15-4-277-285

Keywords:  advanced age; combined surgery aortic valve replacement coronary artery bypass grafting long-term outcomes health-related quality of life

Received / Accepted:  09.06.2018/10.07.2018

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Abstract

The article says on the outcomes of conventional combined surgery in a patient aged 79, NYHA III functional class, EuroSCORE >10: aortic valve replacement (AVR) with coronary arteries bypass grafting (CABG). In 81 months after surgery, the ECHO assessment for aortic pericardial biological prosthesis – the Carpentier-Edwards PERIMOUNT was as follows: the cusps of prosthesis were flexible and quick acting; the peak/mean systolic gradients were close to 20/11 mm Hg that did not exceed postoperative values. No evidence was found for the ischemia's zones of patient's myocardium by means of myocardium scintigraphy. The cardiorespiratory exercise test has confirmed satisfactory level of the patient's physical performance. The value of peakVO2 (14.8 ml/kg/min) was as much as 82% of the required parameters. NYHA II functional class was confirmed. The normal parameters of oxygen pulse (12 ml/bpm), respiratory biomechanics and ventilation- perfusion ratio (Vd/Vt) were established. Neither ischemically significant change in the ST segment nor heart rhythm disturbances was found. In evaluating the health-related quality of patient's life – by the questionnaires of SF-36, DASI index, Minnesota's and Nottingham's Profile – the state of physical and mental health, an emotional state and the role functioning capacity of the patient were estimated as good. Appropriate patient selection is essential for successful combined open surgery for AVR and CABG in the patients of advanced age.

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About Authors

  • Nikitina Tat'yana Georgievna, Dr. Med. Sc., Professor, Head of Department of Cardiology of Acquired Heart Defects; orcid.org/0000-0003-4656-6299
  • Muratov Ravil' Muratovich, Dr. Med. Sc., Professor, Head of Department of Emergency Surgery of Acquired Heart Defects; orcid.org/0000-0003-3321-9028
  • Fadeev Aleksandr Alekseevich, Cand. Tech. Sc., Head of Laboratory for the Use of Polymers in Cardiovascular Surgery; orcid.org/0000-0001-5358-0027
  • Tsitlidze Nino Zurabovna, Cardiologist; orcid.org/0000-0002-4479-4688
  • Glushko Lyudmila Alеksandrovna, Cand. Med. Sc., Head of Group of Pulmonary Samples and Gas Exchange Monitoring, Cardiologist; orcid.org/0000-0002-6532-7261

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