| Autor: |
Cherniavskiĭ MA; Scientific Research Division of Vascular and Interventional Surgery, Scientific Research Division of Cardiothoracic Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia., Gusev AA; Scientific Research Division of Vascular and Interventional Surgery, Scientific Research Division of Cardiothoracic Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia., Chernova DV; Scientific Research Division of Vascular and Interventional Surgery, Scientific Research Division of Cardiothoracic Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia., Iarkov IV; Scientific Research Division of Vascular and Interventional Surgery, Scientific Research Division of Cardiothoracic Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia., Gordeev ML; Scientific Research Division of Vascular and Interventional Surgery, Scientific Research Division of Cardiothoracic Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia. |
| Abstrakt: |
Prevention of neurological complications in cardiosurgical and reconstructive vascular surgery is one of the priority tasks of preserving ability to work and decreasing invalidization of patients in the postoperative period. Presented in the article is a clinical case report regarding multiple-stage treatment of a female patient with a combined aortic defect, coronary pathology, and a multilevel bilateral lesion of the brachiocephalic arteries. The first stage consisted in performing a hybrid operation, i. e., carotid endarterectomy from the right internal carotid artery and stenting of the ostium of the right common carotid artery (CCA). The second stage involved balloon angioplasty with stenting of the left CCA, and the third stage was prosthetic repair of the aortic valve by a mechanical prosthesis with simultaneous coronary artery bypass grafting. The woman was discharged in a satisfactory condition. Described in details is the technique of performing the hybrid vascular operation, followed by substantiating the stagewise nature of surgical interventions. The policy chosen demonstrates effective and safe correction of haemodynamically significant tandem stenoses of brachiocephalic arteries, without neurological complications during treatment of patients with cardiological pathology. |
