Publications by authors named "L G Sichinava"

23 Publications

Minimally invasive multivessel coronary bypass surgery: Angiographic patency data.

J Card Surg 2020 Mar 23;35(3):620-625. Epub 2020 Jan 23.

Department of Cardiac Surgery, FGBUZ Kliničeskaâ bol'nica No 122 imeni L G Sokolova FMBA Rossii, Saint-Petersburg, Russian Federation.

Objective: Minimally invasive multivessel coronary artery bypass grafting (MIM CABG) has demonstrated its safety, effectiveness and high rate of reproducibility. However, minithoracotomy CABG is still rarely performed. In this study, we retrospectively analyze the CT-angiographic graft patency rates for the patients subjected to this operation.

Methods: A total of 245 patients were subjected to MIM CABG by a left minithoracotomy approach between 2014 and 2018. The left internal thoracic artery (LITA) harvesting, proximal, and distal anastomoses were performed under direct vision. The patients then underwent 128-slice computed tomography coronary angiography (CTA). The angiographic results were obtained for 127 (51.8%) patients (the follow-up period of 31.1 ± 7.8 months, from 15 to 45 months). Of the total patients, 204 (83.2%) were followed clinically during the time period from 12 to 56 months.

Results: Complete revascularization was performed for all the patients. The mean number of grafts was 2.6 ± 0.5. The perioperative mortality was 0.4% (1 patient). There were two conversions to sternotomy (0.8%), four reopenings for bleeding (1.6%), three myocardial infarctions (1.2%), and one stroke (0.4%). Twenty-two patients (9.0%) received transfusions. The long-term mortality was 4.4% (nine patients). Three patients (1.5%) suffered from a stroke during the follow-up period. For five patients (2.4%), repeat revascularization was necessary. For the examined patients, the overall graft patency rate was 89.8%, the LITA graft patency rate was 98.4%, the radial artery patency was 100%, and the saphenous vein graft patency was 84.0%.

Conclusions: MIM CABG allows complete surgical revascularization with excellent clinical outcomes and promising angiographic graft patency rates.
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http://dx.doi.org/10.1111/jocs.14439DOI Listing
March 2020

[Development and practical implementation of organ preservation surgery in case of placenta accreta in patients with a scar on the uterus].

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2019 Aug;27(Special Issue):693-698

Center for Family Planning and Reproduction, Moscow, Russia, 117209.

Comparative analysis of methods for preventing/stopping intraoperative hemorrhage during surgical delivery of patients with placenta accreta (temporary balloon-assisted occlusion of common iliac arteries, internal iliac artery ligation; uterine artery embolization - UAE) has shown that internal iliac artery ligation is not effective. UAE and especially balloon-assisted occlusion of common iliac arteries have demonstrated a significantly greater effect due to the temporary 'devascularization' of the uterine corpus. It has been proved that an innovative surgical technique - a lower segment Caesarean section (LSCS) significantly reduces intraoperative blood loss. The main purpose of an alternative uterus cut - anterior placenta previa preserving and bleeding absence before the child removal - has been achieved within all observations. LSCS has caused a significantly smaller (by 1.6 times) amount of intraoperative blood loss than the corporal one. Another innovative surgical technique is metroplasty. It entails removing placenta accreta areas from the uterus with subsequent restoration of the organ integrity. The authors have proved the necessity of autologous advance blood donation and hemodilution strategy, which was first implemented in Moscow Center for Family Planning and Reproduction, and after 2006 was used in all obstetric institutions in Moscow. This allowed reducing the number of blood donations up to 85% and additionally decreased transfusiological risks which is economically valuable as well. Improvement of diagnostic methods, operating techniques, hemostasis, blood volume redistribution and creating an algorithm on its basis has proved the possibility of implementing an organ-, life, health- and fertility preserving approach in cases of placenta accreta in patients with a scar on the uterus after cesarean section. The introduction of the enhanced principles of patient management with placenta accreta has significantly reduced the number of hysterectomies in Moscow (from 48 in 2007 to 8 in 2016), and during the last 2 years no patient with this complication has had a hysterectomy. 12 out of 85 patients who had deliveries in accordance with the developed algorithm, have realized their subsequent fertility.
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http://dx.doi.org/10.32687/0869-866X-2019-27-si1-693-698DOI Listing
August 2019

A multicenter, randomized, phase III study comparing the efficacy and safety of follitropin alpha biosimilar and the original follitropin alpha.

Eur J Obstet Gynecol Reprod Biol 2019 Oct 26;241:6-12. Epub 2019 Jul 26.

IVFarma LLC, Moscow, Russia. Electronic address:

Objective: The aim of the present study was to investigate the therapeutic equivalence between the follitropin alpha biosimilar and the reference medication in women undergoing assisted reproductive technologies (ART).

Study Design: This multicenter, randomized (1:1), embryologist-blinded, parallel-group, comparative phase III study involved 110 women aged 20-35 years old with tubal and/or male factors of infertility. All of the subjects underwent controlled ovarian hyperstimulation (COH) using a gonadotropin-releasing hormone antagonist (GnRH-ant) protocol. Over the 5-day fixed-dose regimen, the women received 150 IU/day of follitropin alpha biosimilar (n = 55) or original follitropin alpha (n = 55), followed by dose adaptation. The primary endpoint for assessing the therapeutic equivalence was the number of retrieved oocytes using a pre-determined clinical equivalence margin of ± 3.4 oocytes.

Results: Similar numbers of oocytes were retrieved in both groups: 12.16 ± 7.28 in the follitropin alpha biosimilar group and 11.62 ± 6.29 in the original follitropin alpha group, with mean difference of 0.546 ± 1.297 oocytes (95% confidence interval [CI]: -2.026, 3.116), p = 0.002 (intention-to-treat [ITT] population). Additionally, no statistically significant differences were found for secondary endpoints: the onset of biochemical (34.7% and 36.7%, p = 0.883), clinical pregnancy (26.5% and 32.7%, p = 0.507), delivery (26.5% and 24.5%, p = 0.817) and take-home baby rate (28.6% and 26.5%, p = 0.816) for the follitropin biosimilar and original follitropin groups (per-protocol [PP] population). Ovarian hyperstimulation syndrome was observed in subjects with a positive pregnancy test in 0% and 3.64% of cases and after triggering ovulation in 7.27% and 3.64% for the follitropin biosimilar and original follitropin groups, respectively.

Conclusions: This study demonstrated similar therapeutic equivalence and safety profiles between the follitropin alpha biosimilar and the reference follitropin in women who underwent COH in GnRH-ant cycles.

Trial Registration Number: 1. Name of the registry: ClinicalTrials.gov.

Trial Registration Number: NCT03088137. Date of registration: 02.03.2017, retrospectively registered. Trial conducted between 08.02.2017 and 17.08.2018, the date of enrollment of the first participant - 08.02.2017. 2. Name of the registry: Russian Ministry of Health, grls.rosminzdrav.ru.

Trial Registration Number: RCT 754. Date of registration: 26.10.2016, prospectively registered.
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http://dx.doi.org/10.1016/j.ejogrb.2019.07.032DOI Listing
October 2019

Transatlantic Air Travel in the Third Trimester of Pregnancy: Does It Affect the Fetus?

AJP Rep 2018 Apr 16;8(2):e71-e73. Epub 2018 Apr 16.

Moscow University School of Medicine, Moscow, Russia.

Most commercial airlines allow pregnant women to fly up to 36 weeks of gestation. Available information suggests that noise, vibration, and cosmic radiation present a small risk for the pregnant air traveler. The goal of the study was to assess the possible effect of transatlantic flights on the condition of the third-trimester fetus. In total, 112 patients were recruited into the study between January 2005 and June 2016. All underwent a transatlantic flight in the third trimester of pregnancy. All underwent nonstress test before and within 12 hours after the transatlantic flight, and 24 hours later. Patients were asked to report changes in fetal movements (FMs), if any, during takeoff, flight itself, and landing. The time of flight varied from 8 to 15 hours; average flight time was 9 ± 3.8 hours. Ninety-eight patients were the passengers of first or business class, and the rest were of economy class. Increased FM during takeoff was reported by 17 patients (15%), no change in FM by 62 (35%), decreased FM by 4 (3.6%). During flight itself, increased FM was reported by 6 pregnant passengers (5.4%), no change in FM by 70 (63%), decreased FM by 8 (7%).
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http://dx.doi.org/10.1055/s-0038-1641584DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903395PMC
April 2018

Perinatal loss in multiple pregnancies: .

Porto Biomed J 2017 Sep-Oct;2(5):245-246. Epub 2017 Sep 1.

Pirogov Russian National Research Medical University (RNRMU), Russia.

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http://dx.doi.org/10.1016/j.pbj.2017.07.163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806894PMC
September 2017
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