R. MAHMUDOV, S. MUSAYEV, F. HUSEYNOV, I. FETULLAYEV, S. MAZANOV

Central Hospital of Oilworkers, Baku, AZERBAIJAN

Introduction: Nakhchivan autonomous republic of Azerbaijan that is not connected with the land to Azerbaijan. In the Nakhchivan Diagnostic Treatment Center that founded in 2007 year has all opportunities to provide cardiovascular medical services. In Nakhchivan Diagnostic Treatment Center the first open-heart surgery operations began in may 2007 with the support of the cardiovascular surgery department of Central Hospital of Oil Workers.

Material and methods: Cardiovascular surgery department of Central Hospital of Oil Workers with the local staff has been performed 189 open-heart operations, 642 coronary angiography and 124 PTCA. The CABG surgery was 108, aortic valve replacement-9, mitral valve replacement-14, congenital-39, peripherial-16, left atrial mixoma- 2, intracardiac foriegn body- 1. CABG: The age of the patieits was 32-82 years, LVEF 20-60%, the average number of grafts 3.3, duration of CPB 59.2 ± 9.2 min and ACC duration was 53.1 ± 9 min. 94 patients were underwent on-pump CABG surgery and 14 patients - off-pump surgery. Off-pump CABG surgery with high epidural anesthesia was performed in 1 patient (awake CABG). In 1 patient was performed 4 vessel bypass + Jatene aneurysmectomy + endoventricular "patch plasty". 3 aortic valve surgeries were due to aortic insufficiency, and 6 were due to aortic stenosis (3-AVR, 2-AVR+CABG, 1- AVR+ mitral commissurotomy). Mitral valve: MVR-7 (redo MVR in 1 patient), MR-6. Congenital: ASD-14,VSD-6, TOF total correction-5, BT shunt in TOF-2, aortic coarctation-3 (redo aortic coarctation in 1 patient), PDA ligation-7, extension of RVOT due to isolated infundibular pulmonary stenosis -2. Peripherial operations: Extraperitoneal unilateral aorto-femoral bypass-1, İlio-femoral bypass-1, femoropopliteal bypass-5, phlebology-9. In 1 case was revision due to bleeding (0.52%) and 1 patient was revised due to kinking of LIMA. Mortality- 2 (1.05%). IABP inserted in two patients. Finally, on 05.03.2010 (two years after first operations) the first open-heart surgery was performed with only the participation of local staff of Nakhchivan autonomous republic.

Conclusion: We believe that the experienced cardiovascular centers should share their experiences with newly established clinics in this area and help them contributing to the development of cardiovascular surgery and invasive cardiology in our country

THE CLINICAL RESULTS OF REOPERATIONS IN THE HEART SURGERY

R. MAHMUDOV, S. MUSAYEV, M. YARADANGULIYEVA, F. HUSEYNOV, I. SHERIFOV

Central Hospital of Oilworkers, Baku, AZERBAIJAN

Introduction: Reoperations due to technical difficulties encountered in cardiac surgery is always in the foreground and difficult to solv.

Material and methods: 19 patients previously undergoing open-heart surgery has been reoperated in our department (10.05.2007-10.01.2011). 11 patients was operated in other hospitals and 9 patients in our department before. Patients (14 male, 5 female) mean age was 47±8.8. The patients first surgeries: open commissurotomy - 6 cases, coronary bypass -9 cases, AVR- 3 cases, permanent epicardial pacemaker lead insertion, functional mitral and tricuspid valve repair - 1 case. 10 patients underwent CABG reoperations,6 patients underwent MVR, 1 patient underwent AVR due to prosthetic valve not fully fit. 1 patient with infected prosthetic valve and assendant aort pseudoaneurizm was underwent aortic root replacement with Freestyle aortic bioprosthesis. 1 patient with previously diagnosed korrected TGA + VSD with previous closure of VSD and MR-III-IV, TR-IV underwent replacement of permanent pacemaker, mitral valve repair and tricuspid annuloplasty. 2 months after in 1 patient previously undergoing modified BT shunt, the shunt had to be downsized . Surgery in all patients started with sternotomy incision. CPB time was 69.7 ±9.7 minutes and duration of the ACC was 52.3±6.7 minutes. In 2 patient was performed off-pump coronary artery bypass surgery.

Results: There was not any bleeding complication associated with sternotomy. Ventricular fibrillation was in 1 patient, returned to the sinus rhythm by an external cardioversion, There was no neurological damage, renal failure and deep sternal infection. 1 patient with MVR operation has been lost due to heart failure after 3 days. Duration of intensive care stay was 3.9±1.9 days and hospital stay was 9.4±2.8 days.

Conclusion: Re-do operations will be seen frequently in open-heart surgery centers in the future and it must be eliminated.

DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF RELATIONS BETWEEN ANGIOGENESIS AND SOME CYTOCHEMICAL PARAMETERS OF PERIPHERAL BLOOD IN THYROID NODES

R.Z.MAHMUDOV

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

Introduction. To sudy diagnostic and prognostic significance of angiogenesis intensity in the bening and malignant nodular enlargement of thyroid gland. To asses presurgical angiogenesis application of some cytochemical parameters peripheral blood elements may be perspective. Although, respective investigations were not actually conducted.

Purpose: To carry out indirect preoperative assessment of angiogenesis by studying angiogenesis intensity in nodular enlargement of thyroid gland and some cytochemical criteria of blood.

Materials and methods. 103 patients were divided into 3 clinic groups: 1) “Goiter” - 35; 2) “Benign thyroid adenoma” - 35; 3) Thyroid cancer – 33 patients. “Oxygen saturation of erythrocytes”, “free and peroxide lipids”, “ribonucleoproteins” were determined cytochemically in the blood samples taken from finger before the operation (1,0 – 5,0 scores). JD31, JD34, VEGF immunohistochemical tests were carried out, location, density, conductivity and angiogenesis intensity were studied morphometrically during postoperative patomorphologic examinations. Correlative statistic analysis was carried out (p; r; c², P=0,95).

Results. No regular statistic reliable correlation was found out in cytochemical parameters of blood and sample nodular tissues between JD31, JD34, VEGF-positivity and vessel density. Statistically reliable correlations were found out between the diagnosis of thyroid cancer and high intensity of JD31, JD34, VEGF-positivity and vessel density. In its turn, there are statistically reliable correlations of various intensity and directions between each of the 4 posoperatively studied indicators of angiogenesis and the 3 cytochemical parameters determined before the operation. The strongest relation is observed between high intensity of angiogenesis parameters and low level of oxygen saturation of erythrocytes (<2,0 scores), and relatively weak relation – between high content of ribonucleoproteins (≥3,0 scores).

Summary. “Oxygen saturation of erythrocytes”, “free and peroxide lipids in blokkd elements”, “ribonucleoproteins in blood elements” in peripheral blood can be used as indirect criteria for preoperative assessment of angiogenesis in malignant thyroid nodules of.

Date: 2014-12-28; view: 722