On the simultaneous implementation of endovascular prosthetics of the aortic valve and abdominal aorta in the central military hospital

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Abstract

The paper presents a clinical case of a 72-year-old patient who, for the first time in a military medical organization, in a hybrid operating room, successfully underwent simultaneous transcatheter aortic valve implantation and endoprosthesis replacement of the abdominal aorta by an endovascular method in a patient with a high surgical risk. In the early postoperative period, acute kidney injury of the 3rd stage developed. Conducted conservative therapy led to regression of signs of renal failure, normalization of serum creatinine (101 mcmol/l) and glomerular filtration rate (64 ml/min/1.73 m2) after 2.5 months. The issues of possible complications and advantages of simultaneous operations on the aorta are discussed. The observation demonstrates the technical feasibility of performing such an operation with a positive clinical result. To assess the risk of possible complications, to conduct a careful selection of patients for simultaneous intervention, a multidisciplinary approach is required with the participation of: a cardiac surgeon, an interventional X-ray surgeon, a doctor of functional diagnostic methods, an anesthesiologist, and a cardiologist.

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About the authors

A. V. Esipov

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: angioiva@mail.ru

заслуженный врач РФ, доктор медицинских наук, доцент, генерал-майор медицинской службы

Russian Federation, Krasnogorsk, Moscow region

A. V. Ivanov

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation; Russian Biotechnological University (ROSBIOTECH)

Author for correspondence.
Email: angioiva@mail.ru
Russian Federation, Krasnogorsk, Moscow region;

S. D. Maksanov

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: angioiva@mail.ru
Russian Federation, Krasnogorsk, Moscow region

V. A. Ivanov

Branch of the S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: angioiva@mail.ru

заслуженный врач РФ, профессор, полковник медицинской службы в отставке

Russian Federation, Moscow

A. N. Lishchuk

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: angioiva@mail.ru

заслуженный врач РФ, профессор, полковник медицинской службы запаса

Russian Federation, Krasnogorsk, Moscow region

R. A. Aliyarov

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: angioiva@mail.ru
Russian Federation, Krasnogorsk, Moscow region

R. M. Shabaev

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation; Russian Biotechnological University (ROSBIOTECH)

Email: angioiva@mail.ru

кандидат медицинских наук

Russian Federation, Krasnogorsk, Moscow region; Moscow

V. I. Baksheev

National Medical Research Center for High Medical Technologies – The A.A.Vishnevsky Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: angioiva@mail.ru

заслуженный врач РФ, доктор медицинских наук, полковник медицинской службы в отставке

Russian Federation, Krasnogorsk, Moscow region

References

  1. Абугов С.А., Поляков Р.С., Чарчян Э.Р. и др. Эндопротезирование при гибридных и этапных операциях на аорте // Кардиол. и сердеч.-сосуд. хир. – 2018. – Т. 11, № 6. – С. 38–44.
  2. Акчурин Р.С., Имаев Т.Э., Комлев А.Е., Покидкин И.А. Гибридная сердечно-сосудистая хирургия – интеграция специализации в хирургии сердца и сосудов на рубеже веков // Кардиологич. вестн. – 2012. – Т. 7, № 1 (19). – С. 47–50.
  3. Борисов И.А., Далинин В.В., Серговенцев А.А., Крайнюков П.Е., Симоненко В.Б. Бесшовные биологические протезы в хирургии аортального стеноза // Клин. мед. – 2020. – Т. 98, № 6. – С. 440–448.
  4. Борисов И.А., Далинин В.В., Симоненко В.Б., Серговенцев А.А., Крайнюков П.Е. Вшиваемые и бесшовные биологические протезы при аортальном стенозе. Опыт 4 лет наблюдения // Клин. и эксперимент. хир. Журн. им. акад. Б.В.Петровского. – 2019. – Т. 7, № 1 (23). – С. 44–53.
  5. Есипов А.В., Абушинов В.В., Алехнович А.В. Новые требования к внутреннему контролю качества и безопасности медицинской деятельности: пути и инструменты их реализации в многопрофильном стационаре (сообщение первое) // Госпит. медиц.: наука и практика. – 2021. – Т. 4, № 1. – С. 45–53.
  6. Клинические рекомендации. Острое повреждение почек (ОПП) / Ассоц. нефрологов, Науч. об-во нефрологов России, Ассоц. анестезиол.-реаниматол. России, Национ. об-во спец. в области гемафереза и экстракорпор. гемокоррекции. – 2020. – 142 с.
  7. Кочкина К.В., Кочкина Т.А., Маштакова О.Б. и др. Эффективность и безопасность одномоментных эндоваскулярных вмешательств при транскатетерной имплантации аортального клапана // Рос. кардиол. журн. – 2016. – Т. 11, № 139. – С. 41–46.
  8. Крайнюков П.Е., Далинин В.В., Борисов И.А., Афонасков О.В. Первый опыт применения бесшовного протеза аортального клапана Perceval S // Воен.-мед. журн. – 2016. – Т. 337, № 8. – С. 28–34.
  9. Binder R.K., Maisano F., Lachat M. First report of simultaneous transcatheter aortic valve replacement, endovascular aortic aneurysm repair, and permanent pacemaker implantation after multi-vessel coronary stenting and left atrial appendage occlusion // Eur. Heart J. – 2015. – Vol. 36, N 37. – P. 2543.
  10. Drury-Smith M., Garnham A., Khogali S. Critical aortic stenosis in a patient with a large saccular abdominal aortic aneurysm: simultaneous transcatheter aortic valve implantation and drive-by endovascular aortic aneurysm repair // Catheter Cardiovasc. Interv. – 2012. – Vol. 80, N 6. – P. 1014–1018.
  11. EuroSCORE II // URL:https://euroscore .org/index.php?id=17&lang=en (дата обращения: 20.02.2023).
  12. Koutsias S., Karaolanis G.I., Papafaklis M.I. et al. Simultaneous Transcatheter Aortic Valve Implantation and Infrarenal Aortic Aneurysm Repair for Severe Aortic Stenosis and Abdominal Aortic Aneurysm: Report of 2 Cases and Literature Review // Vasc. Endovascular Surg. – 2020. – Vol. 54, N 6. – P. 544–548.
  13. Kurra V., Schoenhagen P., Roselli E.E. et al. Prevalence of significant peripheral artery disease in patients evaluated for percutaneous aortic valve insertion: Preprocedural assessment with multidetector computed tomography // J. Thorac Cardiovasc. Surg. – 2009. – Vol. 137, N 5. – P. 1258–1264.
  14. Marchi F., Cerillo A.G., Rizza A. et al. Large Abdominal Aortic Aneurysm in a High-Risk Surgical Patient: Combined Percutaneous Transfemoral TAVI and EVAR Procedure // J. Heart Valve Dis. – 2015. – Vol. 24, N 3. – P. 310–312.
  15. Nordon I.M., Hinchliffe R.J., Loftus I.M., Thompson M.M. Pathophysiology and epidemiology of abdominal aortic aneurysms // Nat. Rev. Cardiol. – 2011. – Vol. 8, N 2. – P. 92–102.
  16. Orejola W.C., Elmann E.M., Wilderman M.J. et al. Combined Transcatheter Aortic Valve Replacement and Endovascular Aortic Repair: A Transfemoral Approach Dilemma // J. Surgery. –2016. – Vol. 4, N 1. – P. 3.
  17. Sato Y., Horiuchi Y., Yahagi K. et al. Simultaneous transcatheter aortic valve implantation and endovascular aneurysm repair in a patient with very severe aortic stenosis with abdominal aortic aneurysm // J. Cardiol. Cases. –2018. – Vol. 17, N 4. – P. 123–125.
  18. Schizas N., Antonopoulos C.N., Patris V. et al. Current issues on simultaneous TAVR (Transcatheter Aortic Valve Replacement) and EVAR (Endovascular Aneurysm Repair) // Clin. Case Rep. – 2021. – Vol. 9, N 7. – P. 10.1002/ccr3.3929.
  19. Toggweiler S., Brinkert M., Fornaro J. et al. Simultaneous endovascular aortic aneurysm repair and transcatheter aortic valve implantation in the hybrid operating room // Cardiovasc. Med. – 2020. – N 23. – P. w02083.
  20. Ullery B.W., Hallett R.L., Fleischmann D. Epidemiology and contemporary management of abdominal aortic aneurysms // Abdom. Radiol. (NY). – 2018. – Vol. 43, N 5. – P. 1032–1043.

Supplementary files

Supplementary Files
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2. Fig. 1. Angiograms of staged aortic valve implantation. 1. Angiography of the aortic root. 2. Predilation of the aortic valve. 3. CorValve aortic valve positioning. 4. Control angiography of the aortic root and ascending aorta

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3. Fig. 2. Control angiogram of the terminal aorta. "Ballerina's legs". 1. The "crown" of the stent graft. Right (2) and left (3) legs of the endoprosthesis. 4. Aortic aneurysm

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4. Fig 3. Dissection (arrow) of the right common femoral artery

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Copyright (c) 2023 Esipov A.V., Ivanov A.V., Maksanov S.D., Ivanov V.A., Lishchuk A.N., Aliyarov R.A., Shabaev R.M., Baksheev V.I.


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