Saratov JOURNAL of Medical and Scientific Research

Bokeria O.L.

Bakulev Center of Cardiovascular Surgery, Department of Surgical Treatment of Interactive Pathology, Professor, Doctor of Medical Science

Evaluation of psychosomatic status of patients in cardiac surgery hospital

Year: 2020, volume 16 Issue: №1 Pages: 24-30
Heading: Cardiology Article type: Original article
Authors: Bockeria O.L., Shvartz V.A., Sokolskaya M.A.
Organization: Bakoulev Scientific Center for Cardiovascular Surgery
Summary:

Purpose: to assess the psychosomatic status and quality of life (QOL) of patients undergoing treatment and examination in a cardiac surgery hospital. Material and Methods. The study included 425 patients divided into 243 (57%) men and 182 (43%) women; median age was 61 (54; 66) years. In addition to the standard clinical examination, the quality of life and psychological status of patients were assessed. Patients completed standardized questionnaires of QOL: the Short Form Medical Outcomes Study (SF36), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), Hospital Anxiety and Depression Scale (HADS). Results. Indicators of the psychological component of the questionnaire were statistically significantly lower in women compared with male patients: vital activity (VT) 45 (30; 60) vs 50 (35; 65) p<0.001, social functioning (SF) 63 (38; 75) vs 64 (50; 88) p<0.001, and the level of anxiety and depression were significantly higher in women 9 (6; 12) vs 6 (3; 9) and 7 (4; 10) vs 5 (3; 8) (p<0.001).The values of the physical component of health were also lower in women: physical functioning (PF) 45 (25; 65) vs 55 (35; 80) p<0.001; bodily pain (BP) 41 (41; 74) vs 51 (41; 74) p<0.001. Low QOL scores and high levels of anxiety and depression were not due to the severity of the disease, men had more severe nosological status. Conclusion. Most of the patients entering the cardiac surgery hospital have clinically expressed anxiety and depression, which have negatively effect on the quality of their life. This is more typical for female patients.

Keywords: quality of life
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Comparative evaluation of autonomic regulation of circulation in patients undergone coronary artery bypass grafting or correction of acquired valvular heart disease

Year: 2018, volume 14 Issue: №1 Pages: 45-49
Heading: Internal Diseases Article type: Short message
Authors: Kiselev A.R., Vulf K.A., Shvartz V.A., Karavaev A.S., Borovkova E.l., Bockeria O.L.
Organization: Bakulev Center of Cardiovascular Surgery, Saratov State Medical University n.a. V.I. Razumovsky Research Institute of Cardiology, Saratov state university
Summary:

The aim of the research was to study the peculiarities of vegetative regulation of blood circulation in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or correction of acquired valvular heart disease (CAVHD). Material and Methods. In this study we included 42 patients (12 women; 63 (57; 67) years), who underwent CABG, and 36 patients (16 women; 58 (47; 65) years) who underwent CAVHD. The synchronous 15 minutes records of electrocardiogram and photoplethysmogram (PPG) were performed in all patients before and after surgery. Time domain and frequency domain measures of heart rate variability (HRV) and index of synchronization between low-frequency (LF) oscillations in HRV and PPG (index S) were analyzed. Results. Most studied autonomic indices did not have statistically significant differences between patients with CABG and CAVHD in the study stages, except for heart rate, which was higher in patients before CAVHD (p=0,013). Conclusion. The values of HRV and index S do not depend on the difference in the clinical status and the features of performed cardiac surgical interventions between patients with CABG and CAVHD.

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Case of successful prosthetics of aortic arch in a patient with congenital deformation of aortic arch in severe hypothermia and circulatory arrest

Year: 2014, volume 10 Issue: №3 Pages: 414-418
Heading: cardiac surgery Article type: Case report
Authors: Bokeria L.A., Bokeria O.L., Arakelyan V.S., Koasary A.K.
Organization: Bakulev Center of Cardiovascular Surgery
Summary:

Atresia of the aortic arch is a rare congenital disease, often accompanied by congenital heart defects. Isolated atresia of the aorta is rare and usually has a complex deformation with multiple aneurysms, bending of the aorta and its branches. This anatomy complicates the exposure and makes surgery technically complicated with conventional approaches. The aim of the work is the presentation of a case of successful prosthetics of aortic arch and a 5-year observation of a patient with congenital deformation of the aortic arch in severe hypothermia and circulatory arrest. The article presents the variant of surgical tactics in treatment of patients with this form of atresia of aortic arch.

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Case of successful surgical correction of combined mitral defect and chronic atrial fibrillation at the elderly patient

Year: 2014, volume 10 Issue: №1 Pages: 129-132
Heading: Surgery Article type: Case report
Authors: Bokeria L.A., Bokeria O.L., Donakonyan S.A., Sivtsev V.S.
Organization: Bakulev Center of Cardiovascular Surgery
Summary:

В статье представлены описание успешного случае процедуры cryomaze в сочетании с протезирование митрального клапана и трехстворчатого аннулопластики на пожилого пациента 71 лет. Следующие особенности клинического случая следует отметить: хроническое фибрилляции предсердий в течение 20 лет, огромный левое предсердие из 348 мл. Как известно из анамнеза, который закрылся митрального комиссуротомия было сделано 39 лет назад. Это клинический случай демонстрирует возможность успешной коррекции сложных комбинированных патологий сердца даже в пожилом возрасте. Кроме того, методика хирургической коррекции дисфункции митрального клапана в сочетании с мерцательной аритмией предусматривает обязательное устранение аритмии. Тщательный диагностика и выбор оптимального хирургического вмешательства комбинированного сердечно-сосудистых заболеваний позволяет достичь хороших результатов даже у пожилых пациентов.

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Influence of low-intensity electromagnetic fields on endothelial function in patients with chronic heart failure

Year: 2014, volume 10 Issue: №1 Pages: 86-92
Heading: Сardiology Article type: Original article
Authors: Bokeria O.L., Kuular A.M.
Organization: Bakulev Center of Cardiovascular Surgery, Moscow State Medical Stomatological University n.a. A. I. Evdokimov
Summary:

Objective: to evaluate the influence of low-intensity electromagnetic fields on endogenous bioresonance therapy on the level of asymmetric dimethylarginine in blood, as well as on the parameters of microcirculation in the assessment of endothelial function in patients with chronic heart failure. Material and Methods. The basic group included 40 patients with chronic heart failure (NYHA II): 17 female and 23 male patients. The average age of the patients was 56,4±10 years. The control group consisted of healthy volunteers (20 patients, including 10 women, 10 men aged 31 ±5 years). Assessment of vasomotor state of the endothelium microcirculation was carried out with the help of laser Dopplerflow-metry on the apparatus LAKK-TEST (T) («Lazma», Russia). After the procedure endogenous bioresonance therapy was held. The intervention by low-intensity electromagnetic fields was carried out with the help of a hardware-software complex IMEDIS-EXPERT mode of endogenous bioresonance therapy for 15 minutes. Vasomotor endothelial function of microcirculation was evaluated. The concentration of an inhibitor of nitric oxide synthases, asymmetric dimethylar-ginine in blood before and after the exposure to the intervention by low-intensity electromagnetic fields was studied. Results. After the endogenous bioresonance therapy the microcirculation M parameter in the main group, on the background of iontophoresis with acetylcholine counted in average6,13±4,7 PF units. After iontophoresis with nitroprusside it was 5,9±3,8 PF units. In the control group the rate of myogenic oscillation amplitude (Am) amounted in average 0,75±0,13 Hz, in the main group it was 0,68±0,26 Hz. Reduction of myogenic tone in the control group was statistically significant (p

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Case report on extensive left atrial myxoma removal with permanent pacemaker implantation

Year: 2013, volume 9 Issue: №2 Pages: 321-324
Heading: Surgery Article type: Case report
Authors: Bokeria L.A., Bokeria O.L, Donakanyan S. A., Biniashvili M.B., Petrosyan A.D.
Organization: Bakulev Center of Cardiovascular Surgery, Moscow State Medical Stomatological University n.a. A. I. Evdokimov
Summary:

Aim: To represent a case report of extensive left atrial myxoma removal with permanent pacemaker implantation. Methods: A 56-year old female patient admitted to the Bakulev Center of Cardiovascular Surgery with cardiac evaluation. She noted progressive chest pain associated with dyspnea and fatigue. After physical examination, transthoracic echocardiography and other methods of evolution confirmed the diagnosis: Tumor of the left atrium. Left atrial dilatation. Left ventricle hypertrophy. Arterial hypertension 2 stage of high risk. Circulatory failure 2 stage (by Strazhesko-Vasilenko), functional class II by NYHA. The huge tumor was successfully excised with closure of atrial septal defect by patch. Results: Transthoracic echocardiography in postoperative period showed a normal left and right ventricular function and no residual shunts. The presence of conduction abnormalities in early postoperative period predicted the need for permanent pacemaker implantation. Conclusions: It must be noted rare occurrence of a huge tumor (myxoma) filling left atrium. Large left atrial tumor is approached by biatrial incision with further excision. It is believed that the case can be beneficial in huge cardiac tumors management. Early detection and surgical treatment of heart tumors can reduce the risk of heart failure, systemic embolization, syncope and sudden cardiac death.

Keywords: heart tumors, myxoma
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