Methods. 152 patients (age 59.5 [55,5-63] years, 104 men, 48 women) with arterial hypertension were included in the study. All patients underwent echocardiography, the assessment of intima-media thickness, cardiointervalography at rest and during active orthostatic test (AOT) with the further assessment of adaptation with the ORTO expert diagnostic system. All patients were divided into three groups according to the obtained results: Group 1 consisted of patients with high adaptation (n = 24), Group 2 patients with altered adaptation mechanisms (n = 66), Group 3 patients with poor adaptation (n = 62).

Results. A 9.5% increase in the intima-media thickness has been found in Group 3 compared to the other study groups (p = 0.0075). Very low frequency power in Group 3 was higher than in Group 1 (p = 0.02). The Et / At ratio in Group 2 and Group 3 was higher compared with Group 1 (p = 0.003). Univariate logistic regression analysis reported the probability of failure of the adaptation mechanisms with increased IMT> 0.9 mm (p = 0.01), Et / At ratio > 1.4 (p = 0.0004) and Et > 60 cm / sec (p = 0.009). Multiple logistic regression reported similar results.

Conclusion. High adaptation was found in 16% of patients with hypertension, stress-altered adaptation mechanisms were observed in 43%, and poor adaptation in 41% of patients. Poor adaptation was associated with increased IMT and predominance of very low frequency in the spectral analysis of heart rate variability as well as with values of the right ventricular diastolic function.

Aim. To assess attitude of patients to coronary arthe in-hospital settings and determining coping stratetery disease (CAD) for evaluating their adaptation to gies used to overcome surgery-related stress.

Materials and methods. 132 male patients (the mean age 61 years) with stable coronary artery disease were included in the study. All patients underwent the assessmentof psychological status performed by clinical psychologists in the preoperative period. The subjective assessment of patients’ psychological state and attitude to the disease was evaluated using the A.E. Lichko questionnaire. The Lazarus “Ways of Coping” questionnaire was used to determine behavioral strategies for coping with stress. Patients’ responsibility for their somatic symptoms was assessed using the health scale “Level of Subjective Control”. Psychological testing was performed on days 5-7 before CABG.

Results. Harmonious, ergopathicand anosognostic types of attitude to the diseaseprevailed in the study group. 114 (80%) patients had a combination of two or more types of attitude to the disease. Harmonious and ergopathic types of attitude were commonly com bined with other types of attitude to the disease (n=96, 73%). The assessment of the subjective level of control reported that internal locus of control was found in 36 patients (27%) and externallocus of control in96 patients (73%). The assessment of coping-strategies showed that 79 (60%) patientsrarely used stress-coping strategies. Moreover, 6 patients (5%) did not use any coping strategies.

Conclusion. Harmonious, ergopathic and anosognostic types of attitude to the disease prevailed in patients with coronary artery disease in the preoperative period. Moreover, external locus of control and the rare use of stress-coping strategies in these patients suggested the need for comprehensive medical and psychological support that should be intriduced in the in-hospital setting.

Aim. To determine the relationships between smoking, coronary artery disease (CAD) and cardiovascular risk factors in the open population of Western Siberia.

Methods. A sample of 1628 men and women aged 25 to 64 years was formed in the Kemerovo region as a part of the multicenter epidemiological study “Ep-idemiology of Cardiovascular Diseases and Their Risk Factors in the Russian Federation”. All patients were divided into three groups according to smoking status: non-smokers, ex-smokers and smokers. The following cardiovascular risk factors were analyzed: arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, overweight, diabetes mellitus, low educational status, unemployment. The statistical data were processed using the logistic regression analysis. The results are presented as odds ratios (ORs) with 95% confidence intervals (CI).

Results. Smoking among women was associated with low educational status (OR 1.92; 1.31-2.80) and unemployment (OR 1.51; 1.01-1.09), whereas ex-smoking / smoking with hypertriglyceridemia (OR 1.47; 1.1-2.14) and low educational status (OR 1.49; 1.102.02). Smoking among men was associated with re duced prevalence of overweight (OR 0.61; 0.41-0.91), low educational status (OR 2.92; 1.99-4.27) and unem-ployment (OR 1.86; 1.12-3.10), whereas ex-smoking / smoking with low educational status (OR 2.49; 1.763.52), and unemployment (OR 1.61; 1.01-2.59), smoking cessation with overweight (OR = 2.32; 1.37-3.94) and low educational status (OR 1.93, 95% CI 1.27-2.94). After eliminating the joint effect of modifying cardiovascular risk factors, only smoking in men was associated with increased risk of coronary artery disease (OR, 1.94; 1,01-3,73).

Conclusion. The obtained associations between several cardiovascular risk factors are consistent with the recent Russian and foreign studies. The findings suggested smoking to be an independent risk factor for coronary artery disease as well as the factor associated with other cardiovascular risk factors.

Aim. To assess levels of interleukin-6 (IL-6) and cardial infarction patients receiving clopidogrel or ticaC-reactive protein (CRP) in ST-segment elevation myogrelor in the in-hospital period.

Methods. 80 patients with STEMI were included in the study. All patients received a loading dose of aspirin (250 mg) and clopidogrel (600 mg) in the ambulance. All patients underwent urgent coronary angiography with the further stenting of the infarct-related artery with bare-metal stents. All patients were assigned to two groups using simple random sampling. Group 1 patients received a daily maintenance dose of clopidogrel 75 mg. Group 2 patients received a maintenance dose of ticagrelor 90 mg twice daily. Plasma levels of IL-6 and CRP were measured on day 1 after the hospital admission before replacing clopidogrel to ticagrelor and on day 7 after switching clopidogrel to ticagrelor (day 8 of the in-hospital period).

Results. Levels of CRP and IL-6 in the early period after STEMI in the groups of patients receiving clopidogrel and ticagrelor were similar (p=0.82 vs. p=0.27, respectively). On day 8, CRP levels in the clopidogrel group were significantly higher than CRP levels in the ticagrelor group on day 8 (25.3 (4.6; 46.4) ml / l vs. 17.5 (4.6; 20.9) mg / l, respectively (p = 0.04). The level of IL-6 in the clopidogrel group on day 8 was significantly higher than the level of IL-6 on day 8 in the ticagrelor group (7.03 (2.7; 11.3) pg / mL, vs. 2.8 (1.8; 4.2) pg / mL, respectively (p = 0.01).

Conclusion. Levels of proinflammatory markers were significantly lower in the ticagrelor group on day 8 after STEMI compared to the clopidogrel group.

Aims. To perform comparative assessment of lesion pattern of the coronary and brachiocephalic arteries. To measure levels of matrix metalloproteinase-9 (MMP-9), relative telomere length and arterial stiffness in stable coronary artery disease patients of different age groups.

Methods. 106 male patients with stable coronary artery disease, functional class 1-3 were included in the study. All patients were assigned to two groups according to their age. Patients of younger age and middle-aged (n=59, 52 [46.5; 55] years) were included in Group 1, and 47 elderly patients (64 [62; 67] years; p<0.001) were included in Group 2. Clinical and demographic data, coronary angiography findings, metabolic parameters, ECHOCG findings, levels of MMP-9, relative telomere length and arterial stiffness were included in the analysis.

Results. Young and middle-aged patients commonly had obesity, elevated low density lipoproteins levels and triglycerides levels. Smokers prevailed in this group. According to coronary angiography, one vessel disease was commonly found in younger patients, whereas mul-tivessel disease in elder patients. However, there were no significant differences found in ECHO-CG parameters and atherosclerotic lessions of brachiocephalic arteries between the study groups. Levels of MMP-9 as an indirect marker of arterial stiffness were elevated in both study groups as well as cardio-ankle vascular index. Relative telomere length was similar in both groups.

Conclusion. Our data allow to assume vascular aging syndrome existence in young and middle age patients, and the severe course of coronary artery disease and ath-erosclerosis likelihood in these groups patients.

Aims. To assess levels of copeptin, inflammatory biomarkers and determine the relationships in patients with myocardial infarction and unstable angina.

Methods. 49 male patients with acute coronary syndrome were included in the study. Patients with myocardial infarction (n=26) aged 64.2±1.6 years were included in Group 1. Patients with unstable angina (n=23) aged 62.1±2.2 years were included in Group 2. The control group (n=20, mean age 57.5 ± 3.3) is represented by healthy subjects without coronary artery disease. Levels of copeptin, endothelin 1, proinflammatory cytokines (IL1 b, IL-6, TNF) were measured in the study groups. The relationships between different clinical, morphological and laboratory parameters were assessed.

Results. Levels of copeptin increased 1 hour after hospital admission in patients with myocardial infarction compared to the control group. Significant increase in copeptin levels was observed 12 hours after hospital admission in patients with myocardial infarction. Therefore, copeptin levels should be measured at a time of hospital admission and 12 hours after it. Levels of IL 1b and IL 6 on day 1 of hospital admission in patients with acute coronary syndrome exceeded reference values. Moreover, a further increase in IL 1b levels on day 6 after myocardial infarction has been observed.

Conclusions. The obtained data confirm the possibility of using copeptin to exclude or confirm myocardial damage, in addition to troponin and serial assessments.

Aim. To assess the impact of chronic arterial hyper-tension on clinical and metabolic adaptation of fullterm newborns.

Methods. 65 full-term neonates born to women with chronic arterial hypertension were included in the study. 42 neonates born to women with arterial hypertension stage I were enrolled into Group 1, and 23 neonates born to mothers with arterial hypertension stage II         were included in Group 2. Levels of renin, angiotensin II, aldosterone, natriuretic peptides, endothelin-1 in umbilical cord blood and peripheral blood were measured with the ELISA. Stable nitric oxide metabolites levels were measured using the Griess assay.

Results. Chronic high blood pressure during pregnancy has been found to affect fetal central nervous system and cardiovascular system. Early neonatal period in infants of women with chronic arterial hypertension is associated with a high incidence of perinatal CNS injury, continuing with little change during the first three months of life. The features of the cardiovascular system in neonates of women with arterial hypertension stage II include hypertension and tachycardia at birth, violation of atrioventricular conduction on the first three days of life, open patent foramen ovale up to the first three months of life, whereas neonates born to women with arterial hyper-tension stage I have hypotension on the first day of life. Elevated levels of angiotensin II in neonates born to women with chronic arterial hypertension at birth and reduced levels of endogenous nitrite in the first three months of life suggest the activation of the renin-angiotensin-aldosterone system in the antenatal period, which may cause endothelial dysfunction in early infancy.

Conclusions.

1.            Chronic high blood pressure in pregnancy is as-sociated with perinatal CNS damage in the newborn, continued during the first three months of life.

2.            Stage 1 of hypertension in pregnancy associated with hypotension in newborns on the first day of life; and stage 2 of hypertension in pregnancy associated with hypertension and tachycardia newborn at birth, a violation of his atrioventricular conduction on the 3rd day of life and preservation until the age of three open oval window.

3.            Chronic high blood pressure in pregnancy is as-sociated with an increase in cord blood levels of angiotensin II decrease in peripheral blood concentration of endogenous nitrite in the age of three months.

Aim: To develop a prediction model for selecting op-timal revascularization strategy for patients with polyvascular disease based on the evaluation of hospital out-comes of various surgical treatment strategies for patients with simultaneous coronary and carotid artery disease.

Methods: 391 patients with combined hemodynamically significant atherosclerotic lesions of the coronary and internal carotid arteries underwent reconstruction heart surgeries. Group 1 patients (n = 151, 38.6%) underwent coronary artery bypass grafting (CABG) and subsequent carotid endarterectomy (CEA). Group 2 patients (n = 141, 36%) underwent combined CABG and CEA. Group 3 patients (n = 28, 7.2%) underwent hybrid percutaneous coronary intervention (PCI) and CEA. Group 4 patients (n = 71, 18.2%) underwent CEA and subsequent CABG. 3 groups of risk factors (clinical and demographic risk factors, risk factors of coronary and cerebrovascular adverse events), were selected to develop the prediction model for evaluating the probability of in-hospital complications, such as death, myocardial infarction, acute cerebrovascular accident / transient ischemic attack, significant hemorrhagic complications > BARC type 3 bleeding. The prognostic coefficients of all risk factors for each surgical treatment strategy were evaluated to select optimal revascularization strategy. Then, the integrated indicators, representing a comprehensive assessment of the risk factors related to each surgical treatment strategy, were calculated. The ROC-analysis was performed to set a threshold allowing improving the quality of the prognosis (sensitivity and specificity).

Results: Clinical and demographic factors and cere-brovascular risk factors were significantly associated with adverse prognosis in Group 1 and 2 patients according to the regression analysis. Coronary and cerebrovascular factors were reported to affect prognosis in patients undergoing hybrid revascularization, whereas clinical and demographic risk factors and cerebrovascular risk factors worsen the prognosis of patients undergoing CEA and subsequent CABG. The prediction model allowed creating an interactive calculator able to determine the probability of adverse cardiovascular events in patients with polyvascular disease undergoing four types of surgical treatment strategies and to select the optimal one that will be associated with a minimal risk of in-hospital complications.

Conclusion: The prediction model and personalized calculator for selecting an optimal surgical treatment strategy based on the comprehensive risk assessment for adverse outcomes (clinical and demographic factors, cor-onary and cerebrovascular factors) allows predicting the probability of adverse cardiovascular events in patients with simultaneous carotid and coronary artery disease.

Aims. To estimate the detection rate of comorbidities in patients admitted for surgical treatment of coronary artery disease (CAD) and to compare surgical treatment options in two cardiac surgery centers.

Methods. All the patients older 18 years who underwent coronary artery bypass grafting in 2014 (isolated or combined coronary artery bypass grafting and heart valve repair or replacement and/or aneurysmectomy) admitted to the Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo (Kemerovo group; n =1166) and in the Federal Center for Cardiovascular Surgery, Chelyabinsk (Chelyabinsk group; n = 1293) were included in the study.

Results. The mean age of patients in the Kemerovo group was 62.5±7.8 years, and in the Chelyabinsk group 61.3±7.8 years (p <0.0001). There were significant differences in the incidence rate of postinfarction cardiosclerosis between Kemerovo and Chelyabinsk (66.7% vs. 85.6%, p<0.0001). Patients in the Kemerovo group commonly had obstructive pulmonary disease (13.9 vs 6.2%, p<0.0001), previous acute cerebrovascular accident (7.1 vs 4.6%, p<0.007), atherosclerosis oflower extremity arteries (10.7 vs 3.2%, p<0.0001), gastroduodenal ulcer (15.3 vs 11.0%, p<0.002) compared to patients in the Chelyabinsk group. On average, there are 0.6±0.02 of the above mentioned dis eases per one patient in Kemerovo and0.4±0.01 in Chelyabinsk (p<0.0001). Patients in the Kemerovo group commonly underwent stenting of coronary arteries (13.0 vs 9.9%, p<0.014) compared to patients in the Chelyabinsk group.

Each fourth patient underwent combined CABG and the other surgeries in Chelyabinsk, whereas in Kemerovo each sixth patient receivedcombined surgical treatment(p<0.0001). The number of combined CABG and left ventricular reconstruction was comparable in both centers.

The linear regression analysis reported that the du-ration of surgery and cardiopulmonary bypass time are statistically significantly associated with the performance of combined surgeries (p<0.0001), the presence of comorbidities (p<0.0001) and patient age (p<0.05).

Aim. To develop an optimized scientifically based approach to medical and diagnostic measures before renal denervation.

Methods. 91 patients with a previously diagnosed primary arterial hypertension aged 54.2 (52.0, 69.3) years

history of arterial hypertension was 11.4±4.2 years. 57 (62.6%) patients had asymptomatic lesions of target or-gans. 34 (37.4%) were present with associated clinical conditions. The average number of classes of antihyper-tensive drugs taken by patients was 4±1.2. 18 patients (19.8%) received aldosterone antagonists. All patients were included in the study. The duration of the positive underwent standard clinical, laboratory and instrumental tests. The quality of life was assessed using the SF-36 questionnaire. Patients’ adherence to treatment was eval-uated using the Morisky-Green test. After therapy optimi-zation and a number of additional diagnostic procedures, true resistant arterial hypertension was detected in 19 pa-tients, of whom 9 were excluded from the study. 4 patients were excluded because of specific anatomy, and 5 patients were allergic to the contrast media.

Results. Optimization of the diagnostic and medical algorithm for managing patients with arterial hy-pertension allowed identifying patients with secondary arterial hypertension, accounted to 8.8% of the study sample, as well as achieving significant reduction of blood pressure according to the 24-hour blood pressure monitoring findings: SBP by 34 ± 12 mm Hg, and DBP by 12 ± 4 mm Hg, compared to the initial values (p = 0.046). The obtained results are comparable in the groups with high and low adherence. 54 patients (77.1%) achieved blood pressure targets. The study groups demonstrated significant improvements of the quality of life and adherence to treatment. The proportion of patients with true resistant arterial hypertension has been identified.

Conclusion. The presented algorithm of selecting patients for renal denervation allows to optimize the management strategy inpatients, who are suspected to suffer from resistant arterial hypertension, and to per-form targeted interventions.

Aim. To evaluate the prognostic role of the renal nerves stimulation in the outcomes of renal denervation with a Vessix Renal Denervation system.

Methods. Ten patients (6 females, 4 males) underwent renal denervation using the Vessix Renal Denervation System (Boston Scientific, Marlborough, MA, USA). The mean age of patients was 51±13 years. All patients underwent MSCT angiography of the renal arteries before renal denervation. 1 patient had an additional renal artery. All patients underwent stimulation of the renal nerves before and after ablation with an evaluation of the blood pressure response. The following primary endpoint were evaluated: the results of invasive blood pressure moni-toring evaluation after the renal nerves stimulation before and after ablation, the results of office blood pressure measurements and 24-hours blood pressure monitoring 1 year after ablation. The rate of treatment optimization in the follow-up was assessed as well.

Results. A significant decrease in SBP and DBP was obtained during office BP monitoring and 24-hours BP monitoring within the 1 year follow-up after renal denervation. The decrease in office blood pressure was detected from the second day after ablation and maintained during the follow-up. 4 patients required less intensive medical therapy. A significant intraoperativedecrease in SBP after the renal nerves stimulation by 34.9±7.3 mm Hg was observed before ablation and 15.4±6.4 mm Hg after (p=0.048). Changes inBP response to the renal nerves stimulation before and after ablation correlated with the results of ablation. A direct correlation of high strength and statistical significance has been found between SBP and DBP response to stimulation and a decrease in office and mean daily SBP and DBP in the follow-up period.

Conclusion. The renal nerves stimulation may be used as an acute endpoint to assess the effectiveness of ablationwith the Vessix Renal Denervation System.

Aim. To assess osteogenic potentialities of a three-di-   components, enzymes and vessels with endothelial lining. mensional osteograft in a mini pig model with artificial   Structural composition of the osteograft is an analogue of vertebral body defect. The osteograft consists of osteo-               embryonic bone tissue, which was the basis for examining the regenerative potentialities of the osteograft in the ex-periment.

Methods. The osteograft was implanted in the defect of the lumbar vertebral body of minipig (6 months old). The animals were withdrawn from the experiment in the period from 14 days to 6 months. In the control series, autobone was implanted in a similar defect. The preparations were examined by morphological methods, and bone tissue density was assessed by MSCT.

Results. Regeneration and integration of the bone tissue of the vertebral body with the defect replaced by the osteograft was by primary angiogenic osteogene sis within one month due to the structural components of the osteograft. When the defect is replaced by autograft, the regeneration and integration of the bone tissue of the vertebral body occur within six months due to the structural components of the recipient.

Conclusion. Formation of the common blood flow of the transplant and recipient vessels is both a factor of integration of the transplant into the homeostatic system of the recipient, and a pathogenic mechanism for optimizing the regeneration of bone tissue defect on the basis of the graft.

Background. The matrix metalloproteinase (MMP) system and their tissue inhibitors (TIMPs) act to control myocardial remodeling processes.

Aim. To evaluate serum levels of MMP-3, -9, TIMP-1,     -2 and their relationships with instrumental parameters of myocardial remodeling after isolated mitral valve replacement.

Methods. All patients enrolled into the mitral stenosis group (n = 24) and the mitral insufficiency group (n=24) underwent measurements of serum levels of MMP-3, -9, TIMP-1, -2 by solid-phase enzyme immunoassay before mitral valve replacement and 1 year after it.

Results. Initial elevated levels of MMP-9 correlated with the left ventricular ejection fraction and the integrated systolic remodeling index. One year after mitral valve replacement, MMP-9 levels decreased by 18.54% in the mitral insufficiency group and by 17.17% in the mitral stenosis group (p -0.05). The decrease was more pronounced with a significant increase in exercise tolerance.

Conclusion. The activation of MMP-9 is closely as-sociated with structural cardiac remodeling and severe changes in exercise tolerance in patients with isolated mitral valve disease.

The article provides an overview of 13 clinical guidelines (Russia, USA, Canada, UK, EU countries) on the management of patients with chronic coronary artery disease and secondary prevention, published in the period 2012-2016. The following drugs / treatment strategies are discussed: 1) phytosterols and soluble dietary fibers, mipomersen, omega-3-fatty acids, lipapheresis, chelates as a therapy aimed at reducing blood lipid levels and risk of cardiovascular events; 2) trimetazidine, nicorandil, transmyocardial laser revas-cularization, acupuncture, spinal cord stimulation as a therapy aimed at relieving pain (in case of refractory angina pectoris).

The review article describes the current role of phospholambane in the regulation of ATP-dependent calcium pump activity and the number of cardiomyocytes, and the possibilities of cardiac contractility modulation as a novel method for treatment of chronic heart failure.

The review article covers the current experience of using various methods for long-term ECG monitoring in the outpatient settings, their advantages and disavantages as well as their role in diagnosis of paroxysmal tachy- and bradyarrhythmias.

Ventricular tachyarrhythmias are among the main problems in cardiology and electrophysiology. Drugs treatment is often ineffective in patients with ventricular tachycardia (VT), while interventional approach is more successful. Nevertheless, despite the progress in visualization and catheter ablation technologies, there is still significant ventricular tachycardia recurrence rate over time. There is a number of reports showing that the main cause of endocardial ablation failure is deep intramural and subepicardial location of arrhythmogenic foci.

An elegant percutaneous technique using a subxyphoid access has been proposed in order to reach the pericardial space. Combination of endoand epicardial mapping and ablation has revolutionized ventricular tachycardia management in patients with structural heart diseases, allowing much better success in specific patient population. This review summarizes current achievements in epicardial mapping and ablation in complex ventricular tachycardia management.

Technological advances in extracorporeal membrane oxygenation and emerging evidence that it improves survival in adults with reversible respiratory failure compared to conventional ventilation has lead to increased utilization of extracorporeal membrane oxygenation in adults, usually in the context of acute respiratory distress syndrome. Refractory status asthmaticus is an uncommon indication for extracorporeal membrane oxygenation. We present a case of near fatal respiratory failure and hypercapnia in a 48-year-old male in status asthmaticus not responsive to optimal ventilatory treatment. The use of veno-venous extracorporeal membrane oxygenation resulted in full recovery with return of normal respiratory function within nine days.

The article presents a clinical case of delayed diagnosis of extra-articular manifestations of ankylosing spondylitis and aortitis. 15 years after the onset of symptoms, this diagnosis was established when the irreversible joint damage and cardiovascular complications were present, namely extra-articular manufestatations of aortitis, i.e. ascending aortic extension and the total aortic insufficiency. This clinical case presents a successful surgical treatment of acquired aortic valve disease. The patient underwent the Bentall-de Bono procedure, including aortic valve replacement and plasty of the ascending aorta with a valved conduit “MedEng-23” (MedEng, Russia). Moreover, the current article highlights the problem of selecting optimal medical therapy (therapy for ankylosing spondylitis and anticoagulants) due to ad-verse drug interactions. The reasons for delayed diagnosis were analyzed. Unfortunately, the main reasons are subjec-tive, i.e. general physicians (non-rheumatologists) do not know well clinical signs and symptoms of this disease as well as imaging findings suggesting this diagnosis.

The article presents the clinical case of a patient with heterozygous family hypercholesterolemia with a retro-spective review of the disease progression. The patient with severe lipid metabolism disorder was referred to the Center of Lipid Disorders at the Kemerovo Regional Clinical Cardiac Dispensary n. a. Academician L.S. Barbarash. The patient underwent selective screening according to the Dutch diagnostic criteria comprising of hypercho lesterolemia phenotype, personal and family history, as well as genetic factors. For patient N. the total cumulative score by the Dutch criteria was 30. The diagnosis of familial hypercholesterolemia (CGS) was confirmed. The patient was given maximum tolerated doses of statins. However, the statin therapy was switched to combined lipidlowering therapy due to its low effectiveness.

Coarctation of the aorta is a congenital disease, which clinical signs and symptoms depend on its anatomy. Coarctation of the aorta may be combined with aortic branches anomalies (in particular, the subclavian arteries) and other congenital heart defects, particularly heart valve diseases and anomalous great vessels. This clinical case demonstrates a late diagnosis of coarctation of the aorta, accidentally found during routine aortography in a 42-years old male patient, suffering from coronary artery disease. Serial computed tomography angiography allowed getting complete information about the region of the interests and per-forming complex analysis of the revealed changes com-pared to invasive angiography. Benefits of computed tomography include relative simplicity, ability to use different protocols and various patients’ positioning with minimal limitations for the further assessment. Computed tomography angiography is a promising method for assessing anatomy of congenital anomalies of the internal organs, vascular system and heart defects, particularly coarctation of the aorta.