Publications by authors named "Y D Sinelnikov"

15 Publications

[Surgical treatment of congenital aortic arch disease].

Khirurgiia (Mosk) 2020 (9):38-42

Topchibashov Research Center of Surgery, Baku, Azerbaijan.

Objective: To report treatment outcomes in patients with congenital aortic arch disease.

Material And Methods: There were 65 patients (45 boys and 20 girls) for the period from 2005 to 2019. Mean age of patients was 53±12 days (range 1-98), weight - 3,3±1,3 kg (range 2.2-4.6). All patients were divided into 2 groups depending on the method of surgical repair. The 1 group included 33 patients who underwent patch repair, the 2 group (=32) - anastomosis in end-to-side fashion.

Results: In group I, recurrent aortic arch coarctation was observed in 16.8% of cases, in group II - only in 4% of cases (=0.02). Analysis of systolic pressure in both groups revealed that arterial hypertension was detected in 39% of cases in group I and only in 9,1% of cases in group II (=0,0025).

Conclusion: Surgical treatment of aortic arch disease using anastomosis in end-to-side fashion is associated with reduced risk of recurrent aortic arch coarctation and residual arterial hypertension in long-term postoperative period.
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October 2020

Immediate Outcomes of Aortic Valve Neocuspidization with Glutaraldehyde-treated Autologous Pericardium: a Multicenter Study.

Braz J Cardiovasc Surg 2020 06 1;35(3):241-248. Epub 2020 Jun 1.

University Duisburg-Essen University Hospital of Essen West German Heart and Vascular Center Essen Essen Germany Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital of Essen, University Duisburg-Essen, Essen, Germany.

Objective: To determine the feasibility of aortic valve neocuspidization (AVNeo) with glutaraldehyde-treated autologous pericardium.

Methods: One hundred and seventy (170) AVNeo (84 males/86 females) were performed from January 2017 through March 2019 in three centers. All the records were prospectively collected and retrospectively reviewed.

Results: Most of the patients were older than 60 years and over 95% were operated for aortic stenosis. Preoperatively, pressure gradients were 69.9±21.3 mmHg for patients with aortic stenosis, and the surgical annular diameter was 21.0±2.0 mm for all patients. Effective orifice area (EOA) and indexed EOA (iEOA) averaged 0.7±0.3 cm2 and 0.4±0.2 cm2/m2 for patients with aortic stenosis before surgery, respectively. There was no conversion to prosthetic aortic valve replacement. Eight patients needed reoperation for bleeding, but no patient needed reoperation due to early infective endocarditis. There were five in-hospital deaths due to noncardiac cause. Compared to preoperative echocardiographic measurements, postoperative peak pressure gradient decreased significantly (-58.7±1.7 mmHg; P<0.001) and reached 11.2±5.6 mmHg, and mean pressure gradient also decreased significantly (-36.8±1.1 mmHg; P<0.001) and reached 6.0±3.5 mmHg. Accordingly, EOA and iEOA increased significantly 2.0 cm2 and 1.0 cm2/m2 (both P<0.001) to reach 2.7±0.6 cm2 and 1.4±0.3 cm2/m2 after surgery, respectively, with minimal significant aortic regurgitation (0.6% > mild).

Conclusion: AVNeo is feasible and reproducible with good clinical results. Hemodynamically, AVNeo produces immediate postoperative low-pressure gradients, large EOA, and minimal regurgitation of the aortic valve. Further studies are necessary to evaluate mid- and long-term evolution.
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June 2020

[Fatal renal and neurological complications after aortic arch repair in newborns].

Khirurgiia (Mosk) 2018(6):77-82

Topchibashev Research Center for Surgery of Healthcare Ministry of the Azerbaijan Republic, Baku, Azerbaijan.

Aim: To evaluate effectiveness and safety of various methods of cerebral and visceral protection during aortic arch surgery in infants.

Material And Methods: Retrospective analysis included 60 patients after aortic arch repair followed by different cerebral protection technique who have been assessed for neurological status and visceral injury in early and long-term postoperative period. Aortic arch surgery with deep hypothermic circulatory arrest for congenital diseases was performed in 26 patients (group 1) and antegrade unilateral selective cerebral perfusion in 34 patients (group 2).

Results: Cerebral complications occurred in 28.5% of patients of the 1 group and in 7.9% of patients of the 2 group.

Conclusion: Odds ratio for neurological event is significantly lower in group 2: 0.17 (0.06-0.69; p=0.02). However, there were more patients with renal dysfunction in this group compared with group 1: 58.7% vs. 23.7% (p=0.02).
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October 2018

Extracorporeal membrane oxygenation for Kawasaki disease: two case reports and the Extracorporeal Life Support Organization experience 1999-2015.

Perfusion 2017 Oct 19;32(7):609-612. Epub 2017 Mar 19.

1 Royal Children's Hospital, Melbourne, Australia.

Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We report the successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for cardiac support in two children with Kawasaki disease: one with acute Kawasaki disease shock syndrome, the other with complications of coronary arteritis and subsequent surgery. We also reviewed the reported experience in the ELSO database and available literature.
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October 2017

Modified reverse aortoplasty versus extended anastomosis in patients with coarctation of the aorta and distal arch hypoplasia.

Eur J Cardiothorac Surg 2018 Jan;53(1):254-261

Department of Congenital Heart Surgery, Siberian Biomedical Research Center Ministry of Health Russian Federation, Novosibirsk, Russian Federation.

Objectives: The aim of our prospective randomized study was to compare modified reverse aortoplasty (MRA) and extended end-to-end anastomosis (EEA).

Methods: We have assessed the operative correction results in 54 infants with coarctation of the aorta and distal aortic arch hypoplasia who underwent primary repair in our institute between July 2013 and February 2014. All of the patients were <12 months old when they had the operation. Patients were randomly assigned to 2 arms: modified reverse subclavian flap angioplasty (MRA group; n = 27) or extended end-to-end anastomosis (EEA group; n = 27).

Results: We found a significant difference in residual arterial hypertension between the groups: 2 (7.7%) patients in the MRA group and 8 (30.8%) patients in the EEA group, respectively (P = 0.03). Risk factors for arterial hypertension were precoarctation area rigidity and endocardial fibroelastosis. During the last follow-up visit, recoarctation was observed in 1 (3.8%) patient in the MRA group and in 2 (7.7%) patients in the EEA group, respectively (P = 0.50). Cox regression analysis showed that the only risk factor for recoarctation was the patient's low weight before surgery [odds ratio (95% confidence interval) 0.016 (0.001-0.51), P = 0.047]. An aortic aneurysm developed in 2 (7.7%) patients in the MRA group; however, no significant difference was found between the groups (P = 0.15).

Conclusions: The results of surgical repair of coarctation of the aorta using modified reverse subclavian flap angioplasty and extended anastomosis were comparable in mortality rates and early postoperative complications. Nevertheless, MRA may be beneficial in reducing residual arterial hypertension at the mid-term follow-up visit.
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January 2018