Purpose. The aim is to analyze the features of aortic valve allografts decellularized with trypsin solution or a combination of the sodium dodecyl sulfate/deoxycholate solution.

Materials and methods. We performed histological, bacteriological and mechanical testing of graft.

Results. It was found that after the removal of cellular elements with trypsin the strength of allograft significantly decreased compared with the control group and the samples exposed to detergent treatment. Histological analysis of aortic allograft specimens showed signifi cantly impaired spatial organization of the connective tissue framework of the valve after the enzymatic treatment.

Conclusion. Detergent decellularization is the preferred method for obtaining cell-free aortic allografts because it can effectively remove the donor cells and maintain the microstructure and biomechanical properties of the valve graft. 

Purpose. Extra treatment of biomaterial with heparin is a promising method of artery xenograft hemocompatibility increase. The study was aimed at experimentally assessing quantitative parameters of unfractionated and low molecular weight heparins immobilization on the biomaterial and their impact on graft hemocompatibility.

Materials and methods. Xenoarteries treated with ethylene glycol diglycidyl ether were used. Unfractionated heparin (UFH) by NPO «Synthez» (Russia) and low molecular weight heparin (LMWH) – enoxaparin sodium by «Clexane» (France) were used to treat the biomaterial. The amount of immobilized heparins was assessed using three independent methods. The impact of heparin on biomaterial hemocompatibility was assessed in vitro.

Results. The amount of immobilized enoxaparin was significantly lower than that of UFH. However, this amount of LMWH was enough for having a smoothing effect on xenogafts surface and decreasing platelet aggregation by 24 %. Biomaterial treatment with both UFH and LMWH signifi cantly decreased blood protein adsorption.

Conclusion. Based on the obtained data we can suggest that enoxaparin sodium has a greater potential for antithrombotic modification of epoxy-treated arterial grafts.

Purpose. The study was aimed at examining structural and functional hepatic changes in an experimental model of chronic hepatic failure due to venous congestion.

Materials and methods. The experimental model of congestive liver was created in male Wistar rats. To model chronic venous congestion the left and intemediate hepatic veins were ligated. The model validity was assessed by biochemical and morphological criteria. In the liver of the experimental rats the signs of stasis, venous congestion, enlarged Disse's space, balloon dystrophy, impaired structure of the lobes and focal hepatocyte necrosis were observed. Statistically significant changes in the main biochemical markers of the functional liver condition showing hepatic failure development were registered in all the study timepoints: 4, 8 and 12 weeks. Those changes due to experimental chronic hepatic failure in their intensity and direction were similar to the changes in patients with tricuspid and mitral disorders.

Conclusion. This experimental congestive liver model can be used for examining liver condition in chronic venous congestion. 

Purpose. Evaluate the level of MBF in the walls of the heart chambers in elderly patients with AS and no coronary heart disease as well as with coronary heart disease before and after surgery.

Materials and methods. We examined intraoperative microcirculatory blood flow (MBF) in the different heart chambers by laser doppler flowmetry in 36 patients over 60 years of age with aortic stenosis (AS), as well as with AS and coronary heart disease (CHD). MBF was assessed using laser-Doppler flowmetry (LDF) in milliliters per100 gtissue per minute.

Results. Before surgery patients with AS and coronary artery disease had the lowest MBF volume rate in the wall of the left ventricle compared with patients with AS and no coronary artery disease. Patients with AS and coronary artery disease demonstrated the most pronounced gradient of the microcirculation level before and after surgery: from the lowest blood fl ow in the left atrium (below 60 mL/100g/ min) to the highest in the right ventricle (above 75 mL/100g/min).

Conclusion. MBF in the walls of the heart chambers in patients with AS and CAD is characterized by the lowest volume of blood flow velocity in the wall of the left ventricle compared with patients with AS and no concomitant coronary heart disease. 

Purpose. The study was aimed at examining type D personality impact on the incidence of subclinical peripheral artery disease in patients with chronic lung conditions.

Materials and methods. 134 chronic lung disease patients (104 males and 30 females), aged 58,9 ± 0,5 year, were examined. DS14 questionnaire was used to diagnose type D personality. People who scored 10 points or more on both dimensions were classified as Type D. Type D (n = 58) and non-type D (n = 76) groups were compared. Color duplex imaging of carotid and lower limb arteries was performed to assess intima-media thickness (IMT), ankle-brachial index (ABI), the presence of atherosclerotic plaques and lesions.

Results. 43,3 % patients were type D. Type D patients more often had both low (< 0,9) and high (> 0,9) ABI. Poor ABI was, consequently, more often determined in type D patients (32,8 %) as compared to non-type D patients (11,8 %; р = 0,038). The type D group also more frequently had at least one peripheral artery affected, atherosclerotic plaques in common carotid and external iliac arteries as compared to that without type D.

Conclusion. Type D patients with chronic lung conditions were more often diagnosed with peripheral artery disease. This further confirms the association between psychological distress and artery disease prevalence first observed in ischemic heart disease patients. 

Purpose. The aim is to analyze the occurrence of pre-hospital mortality from acute myocardial infarction inTomskin 27-years of observation and to develop recommendations for reducing mortality.

Materials and methods. The results of the analysis of 6 076 cases of deaths from acute myocardial infarction in the prehospital setting, registered in the course of research on the WHO program «Register of acute myocardial infarction» in the period from 1984 to 2010.

 Results. It is shown that during the analyzed period of time the level of pre-hospital mortality did not change. Throughout the 27year observation period, the figure was higher in men and in patients younger than 60 years. In the vast majority of deaths from myocardial infarction in the prehospital setting was sudden, significantly reduced the efficiency of the current system in the medical care of patients with acute coronary disease.

Purpose. The aim of the study is to analyze characteristics and the clinical course of pulmonary embolism in patients with diabetes on the basis of the Pulmonary Embolism Register (PE) of deaths inTomskhospitals between 2003 and 2011.

Materials and methods. We studied the autopsy reports and medical records of all patients (712 cases) diagnosed with pulmonary embolism anteand/or postmortem, died between 2003 and 2010. Diabetes mellitus was diagnosed in 141 patients and all of them had moderately severe course of the disease or were sub-or decompensated. 28.57% had a high body mass as well: 31,59 + 8,36 kg/m2 . The ratio of medical to surgical patients was 2.1 : 1.

Results. All patients with diabetes were hospitalized on an emergency basis. 31 patients (21,6 %) stayed in hospital less than a day, so blood clots – the sources of thromboembolism, were formed at home, outside of hospital. The major source of thromboembolism was inferior vena cava branches. At the same time, 31,4 % diabetic patients had thrombi in the right chambers of the heart. Anticoagulants were used in 16,4 % of cases to prevent thromboembolism.

Conclusion. The importance of type 2 diabetes mellitus as a risk factor for thromboembolic complications has been until now underestimated both at the outpatient and hospital stages. 

Purpose. To assess dynamic of hemodynamic and hydrodynamic parameters and procedures’ efficacy in different time periods of initiated renal replacement therapy for systemic inflammatory response syndrome of infectious or non-infectious etiologies.

Material and methods. 242 patients with systemic inflammatory response of infectious and non-infectious genesis were enrolled in a prospective randomized multicenter study. Results. The changes in the parameters of central hemodynamic, hydrodynamic status and gas transmission during renal replacement therapy of constant veno-venous hemofiltration were identified.

Conclusion. Early renal replacement therapy initiation (up to 24 hrs from the time the indications were presented) was proved by the authors to be advantageous.

Purpose. The aim of this research is to study the intragastric pH changes in order to develop an algorithm of gastroduodenal complications prevention and treatment in patients undergone open heart surgery at our institution.

Materials and methods. In a prospective randomized trial (180 patients) the method of predicting gastroduodenal complications was examined in coronary surgery patients based on the hypoxic test and intragastral pH monitoring.

Results. The dynamics of intragastric pH during cardiac surgery and in the early postoperative period was analyzed; its correlation with clinical and laboratory data was studied.

Conclusion. The algorithm for risk assessment, prevention and treatment of gastroduodenal complications was proposed. 

Purpose. Analysis of conditions of formation of occupational risks of arterial hypertension.

Materials and methods. Cross cohort research of prevalence of arterial hypertension and its occupational and traditional risk factors at 4 472 employees of the industrial enterprises, the public and private institutions of theKemerovoregion.

Results. Occupational features influence prevalence of traditional risk factors of arterial hypertension. In system to a complex assessment professional features along with age and an index of weight of a body make the most essential contribution to the frequency of arterial hypertension. The maximum influence of a occupational factor on the frequency of arterial hypertension is noted in the middle age (41–50 years).

Conclusion. Working conditions cause occupational risks of arterial hypertension. Communication of working conditions and prevalence of arterial hypertension is mediated as well by other factors connected with a occupation, in particular, effect of «the healthy worker». 

Analytical review of literature provides information about the features of infection, diagnosis and clinical manifestations of parasitic infection of the heart 

The article highlights the prevention of thromboembolic events in patients with atrial fibrillation. The clinical case is presented and focused on direct thrombin inhibitor dabigatran administration as a secondary prevention strategy of thromboembolism (of an arrhythmogenic origin).