Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis
Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricu...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
A. N. Shamatolskiy [verfasserIn] G. V. Bolshukhin [verfasserIn] A. B. Gamzaev [verfasserIn] M. V. Ryazanov [verfasserIn] V. V. Pichugin [verfasserIn] E. B. Shakhov [verfasserIn] S. A. Fedorov [verfasserIn] V. E. Vaykin [verfasserIn] S. A. Aivazian [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Russisch |
| Erschienen: |
2023 |
|---|
| Schlagwörter: |
tricuspid valve infective endocarditis |
|---|
| Übergeordnetes Werk: |
In: Инновационная медицина Кубани - Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021, (2023), 4, Seite 82-90 |
|---|---|
| Übergeordnetes Werk: |
year:2023 ; number:4 ; pages:82-90 |
| Links: |
|---|
| DOI / URN: |
10.35401/2541-9897-2023-8-4-82-90 |
|---|
| Katalog-ID: |
DOAJ092939961 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | DOAJ092939961 | ||
| 003 | DE-627 | ||
| 005 | 20240414122712.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240412s2023 xx |||||o 00| ||rus c | ||
| 024 | 7 | |a 10.35401/2541-9897-2023-8-4-82-90 |2 doi | |
| 035 | |a (DE-627)DOAJ092939961 | ||
| 035 | |a (DE-599)DOAJ56e03390f53649e0b0d014959758e33b | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a rus | ||
| 050 | 0 | |a RC254-282 | |
| 050 | 0 | |a RC666-701 | |
| 050 | 0 | |a RD1-811 | |
| 050 | 0 | |a RC86-88.9 | |
| 100 | 0 | |a A. N. Shamatolskiy |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. | ||
| 650 | 4 | |a tricuspid valve infective endocarditis | |
| 650 | 4 | |a tricuspid valve reconstruction | |
| 650 | 4 | |a tricuspid valve replacement | |
| 653 | 0 | |a Neoplasms. Tumors. Oncology. Including cancer and carcinogens | |
| 653 | 0 | |a Diseases of the circulatory (Cardiovascular) system | |
| 653 | 0 | |a Surgery | |
| 653 | 0 | |a Medical emergencies. Critical care. Intensive care. First aid | |
| 700 | 0 | |a G. V. Bolshukhin |e verfasserin |4 aut | |
| 700 | 0 | |a A. B. Gamzaev |e verfasserin |4 aut | |
| 700 | 0 | |a M. V. Ryazanov |e verfasserin |4 aut | |
| 700 | 0 | |a V. V. Pichugin |e verfasserin |4 aut | |
| 700 | 0 | |a E. B. Shakhov |e verfasserin |4 aut | |
| 700 | 0 | |a S. A. Fedorov |e verfasserin |4 aut | |
| 700 | 0 | |a V. E. Vaykin |e verfasserin |4 aut | |
| 700 | 0 | |a S. A. Aivazian |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i In |t Инновационная медицина Кубани |d Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021 |g (2023), 4, Seite 82-90 |w (DE-627)1760593621 |x 25419897 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g number:4 |g pages:82-90 |
| 856 | 4 | 0 | |u https://doi.org/10.35401/2541-9897-2023-8-4-82-90 |z kostenfrei |
| 856 | 4 | 0 | |u https://doaj.org/article/56e03390f53649e0b0d014959758e33b |z kostenfrei |
| 856 | 4 | 0 | |u https://www.innovmedkub.ru/jour/article/view/769 |z kostenfrei |
| 856 | 4 | 2 | |u https://doaj.org/toc/2541-9897 |y Journal toc |z kostenfrei |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_DOAJ | ||
| 951 | |a AR | ||
| 952 | |j 2023 |e 4 |h 82-90 | ||
| author_variant |
a n s ans g v b gvb a b g abg m v r mvr v v p vvp e b s ebs s a f saf v e v vev s a a saa |
|---|---|
| matchkey_str |
article:25419897:2023----::ugclramnmtosotiupdavif |
| hierarchy_sort_str |
2023 |
| callnumber-subject-code |
RC |
| publishDate |
2023 |
| allfields |
10.35401/2541-9897-2023-8-4-82-90 doi (DE-627)DOAJ092939961 (DE-599)DOAJ56e03390f53649e0b0d014959758e33b DE-627 ger DE-627 rakwb rus RC254-282 RC666-701 RD1-811 RC86-88.9 A. N. Shamatolskiy verfasserin aut Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement Neoplasms. Tumors. Oncology. Including cancer and carcinogens Diseases of the circulatory (Cardiovascular) system Surgery Medical emergencies. Critical care. Intensive care. First aid G. V. Bolshukhin verfasserin aut A. B. Gamzaev verfasserin aut M. V. Ryazanov verfasserin aut V. V. Pichugin verfasserin aut E. B. Shakhov verfasserin aut S. A. Fedorov verfasserin aut V. E. Vaykin verfasserin aut S. A. Aivazian verfasserin aut In Инновационная медицина Кубани Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021 (2023), 4, Seite 82-90 (DE-627)1760593621 25419897 nnns year:2023 number:4 pages:82-90 https://doi.org/10.35401/2541-9897-2023-8-4-82-90 kostenfrei https://doaj.org/article/56e03390f53649e0b0d014959758e33b kostenfrei https://www.innovmedkub.ru/jour/article/view/769 kostenfrei https://doaj.org/toc/2541-9897 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2023 4 82-90 |
| spelling |
10.35401/2541-9897-2023-8-4-82-90 doi (DE-627)DOAJ092939961 (DE-599)DOAJ56e03390f53649e0b0d014959758e33b DE-627 ger DE-627 rakwb rus RC254-282 RC666-701 RD1-811 RC86-88.9 A. N. Shamatolskiy verfasserin aut Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement Neoplasms. Tumors. Oncology. Including cancer and carcinogens Diseases of the circulatory (Cardiovascular) system Surgery Medical emergencies. Critical care. Intensive care. First aid G. V. Bolshukhin verfasserin aut A. B. Gamzaev verfasserin aut M. V. Ryazanov verfasserin aut V. V. Pichugin verfasserin aut E. B. Shakhov verfasserin aut S. A. Fedorov verfasserin aut V. E. Vaykin verfasserin aut S. A. Aivazian verfasserin aut In Инновационная медицина Кубани Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021 (2023), 4, Seite 82-90 (DE-627)1760593621 25419897 nnns year:2023 number:4 pages:82-90 https://doi.org/10.35401/2541-9897-2023-8-4-82-90 kostenfrei https://doaj.org/article/56e03390f53649e0b0d014959758e33b kostenfrei https://www.innovmedkub.ru/jour/article/view/769 kostenfrei https://doaj.org/toc/2541-9897 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2023 4 82-90 |
| allfields_unstemmed |
10.35401/2541-9897-2023-8-4-82-90 doi (DE-627)DOAJ092939961 (DE-599)DOAJ56e03390f53649e0b0d014959758e33b DE-627 ger DE-627 rakwb rus RC254-282 RC666-701 RD1-811 RC86-88.9 A. N. Shamatolskiy verfasserin aut Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement Neoplasms. Tumors. Oncology. Including cancer and carcinogens Diseases of the circulatory (Cardiovascular) system Surgery Medical emergencies. Critical care. Intensive care. First aid G. V. Bolshukhin verfasserin aut A. B. Gamzaev verfasserin aut M. V. Ryazanov verfasserin aut V. V. Pichugin verfasserin aut E. B. Shakhov verfasserin aut S. A. Fedorov verfasserin aut V. E. Vaykin verfasserin aut S. A. Aivazian verfasserin aut In Инновационная медицина Кубани Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021 (2023), 4, Seite 82-90 (DE-627)1760593621 25419897 nnns year:2023 number:4 pages:82-90 https://doi.org/10.35401/2541-9897-2023-8-4-82-90 kostenfrei https://doaj.org/article/56e03390f53649e0b0d014959758e33b kostenfrei https://www.innovmedkub.ru/jour/article/view/769 kostenfrei https://doaj.org/toc/2541-9897 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2023 4 82-90 |
| allfieldsGer |
10.35401/2541-9897-2023-8-4-82-90 doi (DE-627)DOAJ092939961 (DE-599)DOAJ56e03390f53649e0b0d014959758e33b DE-627 ger DE-627 rakwb rus RC254-282 RC666-701 RD1-811 RC86-88.9 A. N. Shamatolskiy verfasserin aut Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement Neoplasms. Tumors. Oncology. Including cancer and carcinogens Diseases of the circulatory (Cardiovascular) system Surgery Medical emergencies. Critical care. Intensive care. First aid G. V. Bolshukhin verfasserin aut A. B. Gamzaev verfasserin aut M. V. Ryazanov verfasserin aut V. V. Pichugin verfasserin aut E. B. Shakhov verfasserin aut S. A. Fedorov verfasserin aut V. E. Vaykin verfasserin aut S. A. Aivazian verfasserin aut In Инновационная медицина Кубани Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021 (2023), 4, Seite 82-90 (DE-627)1760593621 25419897 nnns year:2023 number:4 pages:82-90 https://doi.org/10.35401/2541-9897-2023-8-4-82-90 kostenfrei https://doaj.org/article/56e03390f53649e0b0d014959758e33b kostenfrei https://www.innovmedkub.ru/jour/article/view/769 kostenfrei https://doaj.org/toc/2541-9897 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2023 4 82-90 |
| allfieldsSound |
10.35401/2541-9897-2023-8-4-82-90 doi (DE-627)DOAJ092939961 (DE-599)DOAJ56e03390f53649e0b0d014959758e33b DE-627 ger DE-627 rakwb rus RC254-282 RC666-701 RD1-811 RC86-88.9 A. N. Shamatolskiy verfasserin aut Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement Neoplasms. Tumors. Oncology. Including cancer and carcinogens Diseases of the circulatory (Cardiovascular) system Surgery Medical emergencies. Critical care. Intensive care. First aid G. V. Bolshukhin verfasserin aut A. B. Gamzaev verfasserin aut M. V. Ryazanov verfasserin aut V. V. Pichugin verfasserin aut E. B. Shakhov verfasserin aut S. A. Fedorov verfasserin aut V. E. Vaykin verfasserin aut S. A. Aivazian verfasserin aut In Инновационная медицина Кубани Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021 (2023), 4, Seite 82-90 (DE-627)1760593621 25419897 nnns year:2023 number:4 pages:82-90 https://doi.org/10.35401/2541-9897-2023-8-4-82-90 kostenfrei https://doaj.org/article/56e03390f53649e0b0d014959758e33b kostenfrei https://www.innovmedkub.ru/jour/article/view/769 kostenfrei https://doaj.org/toc/2541-9897 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 2023 4 82-90 |
| language |
Russian |
| source |
In Инновационная медицина Кубани (2023), 4, Seite 82-90 year:2023 number:4 pages:82-90 |
| sourceStr |
In Инновационная медицина Кубани (2023), 4, Seite 82-90 year:2023 number:4 pages:82-90 |
| format_phy_str_mv |
Article |
| institution |
findex.gbv.de |
| topic_facet |
tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement Neoplasms. Tumors. Oncology. Including cancer and carcinogens Diseases of the circulatory (Cardiovascular) system Surgery Medical emergencies. Critical care. Intensive care. First aid |
| isfreeaccess_bool |
true |
| container_title |
Инновационная медицина Кубани |
| authorswithroles_txt_mv |
A. N. Shamatolskiy @@aut@@ G. V. Bolshukhin @@aut@@ A. B. Gamzaev @@aut@@ M. V. Ryazanov @@aut@@ V. V. Pichugin @@aut@@ E. B. Shakhov @@aut@@ S. A. Fedorov @@aut@@ V. E. Vaykin @@aut@@ S. A. Aivazian @@aut@@ |
| publishDateDaySort_date |
2023-01-01T00:00:00Z |
| hierarchy_top_id |
1760593621 |
| id |
DOAJ092939961 |
| language_de |
russisch |
| fullrecord |
<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ092939961</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240414122712.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240412s2023 xx |||||o 00| ||rus c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.35401/2541-9897-2023-8-4-82-90</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ092939961</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ56e03390f53649e0b0d014959758e33b</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">rus</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC254-282</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC666-701</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD1-811</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC86-88.9</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">A. N. Shamatolskiy</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tricuspid valve infective endocarditis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tricuspid valve reconstruction</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tricuspid valve replacement</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Neoplasms. Tumors. Oncology. Including cancer and carcinogens</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the circulatory (Cardiovascular) system</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Surgery</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medical emergencies. Critical care. Intensive care. First aid</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">G. V. Bolshukhin</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">A. B. Gamzaev</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">M. V. Ryazanov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">V. V. Pichugin</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">E. B. Shakhov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">S. A. Fedorov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">V. E. Vaykin</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">S. A. Aivazian</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Инновационная медицина Кубани</subfield><subfield code="d">Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021</subfield><subfield code="g">(2023), 4, Seite 82-90</subfield><subfield code="w">(DE-627)1760593621</subfield><subfield code="x">25419897</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">year:2023</subfield><subfield code="g">number:4</subfield><subfield code="g">pages:82-90</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.35401/2541-9897-2023-8-4-82-90</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/56e03390f53649e0b0d014959758e33b</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://www.innovmedkub.ru/jour/article/view/769</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/2541-9897</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="j">2023</subfield><subfield code="e">4</subfield><subfield code="h">82-90</subfield></datafield></record></collection>
|
| callnumber-first |
R - Medicine |
| author |
A. N. Shamatolskiy |
| spellingShingle |
A. N. Shamatolskiy misc RC254-282 misc RC666-701 misc RD1-811 misc RC86-88.9 misc tricuspid valve infective endocarditis misc tricuspid valve reconstruction misc tricuspid valve replacement misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens misc Diseases of the circulatory (Cardiovascular) system misc Surgery misc Medical emergencies. Critical care. Intensive care. First aid Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis |
| authorStr |
A. N. Shamatolskiy |
| ppnlink_with_tag_str_mv |
@@773@@(DE-627)1760593621 |
| format |
electronic Article |
| delete_txt_mv |
keep |
| author_role |
aut aut aut aut aut aut aut aut aut |
| collection |
DOAJ |
| remote_str |
true |
| callnumber-label |
RC254-282 |
| illustrated |
Not Illustrated |
| issn |
25419897 |
| topic_title |
RC254-282 RC666-701 RD1-811 RC86-88.9 Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis tricuspid valve infective endocarditis tricuspid valve reconstruction tricuspid valve replacement |
| topic |
misc RC254-282 misc RC666-701 misc RD1-811 misc RC86-88.9 misc tricuspid valve infective endocarditis misc tricuspid valve reconstruction misc tricuspid valve replacement misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens misc Diseases of the circulatory (Cardiovascular) system misc Surgery misc Medical emergencies. Critical care. Intensive care. First aid |
| topic_unstemmed |
misc RC254-282 misc RC666-701 misc RD1-811 misc RC86-88.9 misc tricuspid valve infective endocarditis misc tricuspid valve reconstruction misc tricuspid valve replacement misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens misc Diseases of the circulatory (Cardiovascular) system misc Surgery misc Medical emergencies. Critical care. Intensive care. First aid |
| topic_browse |
misc RC254-282 misc RC666-701 misc RD1-811 misc RC86-88.9 misc tricuspid valve infective endocarditis misc tricuspid valve reconstruction misc tricuspid valve replacement misc Neoplasms. Tumors. Oncology. Including cancer and carcinogens misc Diseases of the circulatory (Cardiovascular) system misc Surgery misc Medical emergencies. Critical care. Intensive care. First aid |
| format_facet |
Elektronische Aufsätze Aufsätze Elektronische Ressource |
| format_main_str_mv |
Text Zeitschrift/Artikel |
| carriertype_str_mv |
cr |
| hierarchy_parent_title |
Инновационная медицина Кубани |
| hierarchy_parent_id |
1760593621 |
| hierarchy_top_title |
Инновационная медицина Кубани |
| isfreeaccess_txt |
true |
| familylinks_str_mv |
(DE-627)1760593621 |
| title |
Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis |
| ctrlnum |
(DE-627)DOAJ092939961 (DE-599)DOAJ56e03390f53649e0b0d014959758e33b |
| title_full |
Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis |
| author_sort |
A. N. Shamatolskiy |
| journal |
Инновационная медицина Кубани |
| journalStr |
Инновационная медицина Кубани |
| callnumber-first-code |
R |
| lang_code |
rus |
| isOA_bool |
true |
| recordtype |
marc |
| publishDateSort |
2023 |
| contenttype_str_mv |
txt |
| container_start_page |
82 |
| author_browse |
A. N. Shamatolskiy G. V. Bolshukhin A. B. Gamzaev M. V. Ryazanov V. V. Pichugin E. B. Shakhov S. A. Fedorov V. E. Vaykin S. A. Aivazian |
| class |
RC254-282 RC666-701 RD1-811 RC86-88.9 |
| format_se |
Elektronische Aufsätze |
| author-letter |
A. N. Shamatolskiy |
| doi_str_mv |
10.35401/2541-9897-2023-8-4-82-90 |
| author2-role |
verfasserin |
| title_sort |
surgical treatment methods for tricuspid valve infective endocarditis |
| callnumber |
RC254-282 |
| title_auth |
Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis |
| abstract |
Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. |
| abstractGer |
Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. |
| abstract_unstemmed |
Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency. |
| collection_details |
GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ |
| container_issue |
4 |
| title_short |
Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis |
| url |
https://doi.org/10.35401/2541-9897-2023-8-4-82-90 https://doaj.org/article/56e03390f53649e0b0d014959758e33b https://www.innovmedkub.ru/jour/article/view/769 https://doaj.org/toc/2541-9897 |
| remote_bool |
true |
| author2 |
G. V. Bolshukhin A. B. Gamzaev M. V. Ryazanov V. V. Pichugin E. B. Shakhov S. A. Fedorov V. E. Vaykin S. A. Aivazian |
| author2Str |
G. V. Bolshukhin A. B. Gamzaev M. V. Ryazanov V. V. Pichugin E. B. Shakhov S. A. Fedorov V. E. Vaykin S. A. Aivazian |
| ppnlink |
1760593621 |
| callnumber-subject |
RC - Internal Medicine |
| mediatype_str_mv |
c |
| isOA_txt |
true |
| hochschulschrift_bool |
false |
| doi_str |
10.35401/2541-9897-2023-8-4-82-90 |
| callnumber-a |
RC254-282 |
| up_date |
2024-07-03T14:30:21.645Z |
| _version_ |
1803568568489476096 |
| fullrecord_marcxml |
<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ092939961</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240414122712.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240412s2023 xx |||||o 00| ||rus c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.35401/2541-9897-2023-8-4-82-90</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ092939961</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ56e03390f53649e0b0d014959758e33b</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">rus</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC254-282</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC666-701</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD1-811</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC86-88.9</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">A. N. Shamatolskiy</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Surgical Treatment Methods for Tricuspid Valve Infective Endocarditis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction: In recent years, there has been a significant increase in the incidence of tricuspid valve infective endocarditis (IE), which is associated with both the increased number of invasive examinations and procedures and the high rates of intravenous drug use. The initial treatment for tricuspid valve IE was surgical removal of the focus of infection and restoration of intracardiac hemodynamics.Reconstructive surgery aimed at preserving the valve is the preferred method of surgical treatment. If a valve-preserving operation is not possible due to significant valvular apparatus destruction, implantation of artificial heart valves (both mechanical and biological) is the method of choice.Objective: To analyze the results of reconstructive valve-preserving surgery and tricuspid valve replacement for tricuspid valve IE treatment.Materials and methods: In the Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev (Nizhny Novgorod, Russian Federation) 110 patients underwent surgery for tricuspid valve IE. Primary surgery was performed in 97 patients, and 13 patients underwent repeated surgery. The patients were divided into 2 groups based on the chosen surgical method for correcting tricuspid valve disease. Group 1 included 62 patients who successfully underwent tricuspid valve replacement: mechanical prostheses in 10 patients and biological prostheses in 52 patients. Group 2 included 38 patients who underwent reconstructive valvepreserving surgery. All patients underwent De Vega annuloplasty. In 10 patients it was directly associated with bicuspidalization of the tricuspid valve and plastic surgery of intact leaflets. Two patients had suture annuloplasty of the tricuspid valve based on the modified technique. In 2 of 3 patients, an infected right atrial thrombus was removed. Three patients underwent removal of the left ventricular wall abscess and aortic valve replacement for critical stenosis. After translocation of the chords, triangular resection of the anterior leaflet was performed to separate the chord of the left side of the chest and the myxoma of the right and left chest.Results: In the early postoperative period, no valverelated complications were observed in group 1. The most common nonlethal complication was a third-degree atrioventricular block. Multiple organ dysfunction syndrome occurred in 3 patients; cardiac tamponade was reported in 2 patients, and 1 patient had postoperative bleeding that required resternotomy for serous mediastinitis in the midterm period and reosteosynthesis. At the hospital stage, 1 patient from group 1 died, whereas there were no deaths in group 2. In-hospital mortality in the groups of operated patients was 0.9%.Functional ultrasound imaging findings in the postoperative period show that patients from group 1 had the peak gradient across the prosthetic tricuspid valve of 9.4 ± 1.8 mm Hg, while the mean gradient was 5.8 ± 1.75 mm Hg. There was a significant decrease in the estimated right ventricle pressure from 54.0 ± 16.2 to 35.0 ± 5.5 mm Hg. In group 2 tricuspid valve regurgitation was not observed in 27 patients, while mild and moderate regurgitation was reported in 8 and 3 patients, respectively. The peak gradient during the tricuspid valve reconstruction was 6.2 ± 1.7 mm Hg, while the mean gradient was 2.8 ± 0.75 mm Hg. The annulus fibrosus size during tricuspid valve annuloplasty averaged 30.8 ± 2.5 (2833) mm. There was a decrease in the right ventricle pressure from 44.0 ± 18.4 to 32.0 ± 7.3 mm Hg. In the mid-term followup, surviving patients were classified as NYHA classes I-II. Of 110 patients discharged from the clinic, we were able to trace the fate of 69 patients, which accounted for 62.7%. In the long-term period, 3 patients from group 1 died. Thus, longterm mortality in the general group was 2.72%.Conclusions: Reconstructive surgery has significant advantages over tricuspid valve replacement using various artificial heart valve models: lower rates of in-hospital and long-term mortality and specific complications, higher quality of life. Compliance with principles and methods of pathogenetic treatment of electrodeinduced IE guarantees a success in the cohort of severe patients. The technique of reconstruction and restoration of tricuspid valve structures and functions in case of active tricuspid valve IE with detachment of the chords and destruction of the leaflets demonstrated high surgical efficiency.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tricuspid valve infective endocarditis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tricuspid valve reconstruction</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">tricuspid valve replacement</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Neoplasms. Tumors. Oncology. Including cancer and carcinogens</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the circulatory (Cardiovascular) system</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Surgery</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medical emergencies. Critical care. Intensive care. First aid</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">G. V. Bolshukhin</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">A. B. Gamzaev</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">M. V. Ryazanov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">V. V. Pichugin</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">E. B. Shakhov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">S. A. Fedorov</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">V. E. Vaykin</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">S. A. Aivazian</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Инновационная медицина Кубани</subfield><subfield code="d">Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1, 2021</subfield><subfield code="g">(2023), 4, Seite 82-90</subfield><subfield code="w">(DE-627)1760593621</subfield><subfield code="x">25419897</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">year:2023</subfield><subfield code="g">number:4</subfield><subfield code="g">pages:82-90</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.35401/2541-9897-2023-8-4-82-90</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doaj.org/article/56e03390f53649e0b0d014959758e33b</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://www.innovmedkub.ru/jour/article/view/769</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="u">https://doaj.org/toc/2541-9897</subfield><subfield code="y">Journal toc</subfield><subfield code="z">kostenfrei</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_USEFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">SYSFLAG_A</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">GBV_DOAJ</subfield></datafield><datafield tag="951" ind1=" " ind2=" "><subfield code="a">AR</subfield></datafield><datafield tag="952" ind1=" " ind2=" "><subfield code="j">2023</subfield><subfield code="e">4</subfield><subfield code="h">82-90</subfield></datafield></record></collection>
|
| score |
7.400672 |