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Papers by Valery Arakelyan
RUDN Journal of Medicine, 2021
Relevance . Treatment of diffuse lesions of the arteries of the lower extremities is often reduce... more Relevance . Treatment of diffuse lesions of the arteries of the lower extremities is often reduced to primary amputation at the hip level, since the healing of trophic ulcers is not guaranteed during arterial reconstruction. Profundoplasty without distal bypass surgery can be considered an alternative method. The aim of this study is to compare the long-term results of distal shunting and isolated profundoplasty in patients with diffuse lesions of the lower limb arteries and trophic ischemic ulcers. Materials and Methods . The study included 86 patients with diffuse lesions of the lower limb arteries. There were 52 (60.4%) men and 34 (39.6%) women. The average age was 67.3 16.8 years. All patients had diffuse lesions of the arteries below the pupar ligament, the state of the lower leg arteries was 5-8.5 points on the Rutherford scale, in all cases there were trophic ulcers. Group 1 included 48 patients who underwent reconstruction of the leg arteries. Group 2 consisted of 38 individ...
Kreativnaya kardiologiya, 2015
Interactive CardioVascular and Thoracic Surgery, 2009
European Journal of Cardio-Thoracic Surgery, 2005
Objective: Operation for aortic recoarctation and/or residual hypoplastic arch represents a surgi... more Objective: Operation for aortic recoarctation and/or residual hypoplastic arch represents a surgical challenge because of surrounding scar tissue in the coarctation area, hazard of spinal cord ischemia due to aortic cross-clamping, laceration of the recurrent nerve, and the choice of the best approach. We demonstrate the results of 52 operations of an extra anatomically bypass technique via right thoracotomy approach without establishment of cardiopulmonary bypass. Methods: Since 1987, 52 patients underwent extra anatomically positioned ascendingdescending bypass grafting. Indication was aortic recoarctation with concomitant hypoplastic aortic arch (45 patients), atypical coarctation of aortic arch (2 patients), congenital anomalies of aortic arch (2 patients) and concomitant aortic coarctation and associated cardiac problems that required surgical repair (2 patient), infected stent-graft of descending aorta (1 patient). Mean age was 19.3 years. Systolic pressure gradients at rest ranged from 35 to 90 mmHg; upper extremity hypertension was present in all patients. Operative technique consisted of performing aorta ascending-descending bypass graft size 16 or 18 mm in diameter, via right thoracotomy (in 51 patient) or sternotomy (in 1 patient). Results: The mortality rate was 1.9% (1/52). Five patients returned to the operating room (in 3-5 days after operation) for a lymphorrhea complication. An arterial pressure gradient in the limbs was totally corrected. During a follow-up period of actually 79G54 months, no adverse event was noticed and antihypertensive medication was stopped in all patients. Conclusions: Ascending-to-descending aortic bypass via right thoracotomy is a safe and effective method for management complex (re-) coarctation and hypoplastic aortic arch.
RUDN Journal of Medicine, 2021
Relevance . Treatment of diffuse lesions of the arteries of the lower extremities is often reduce... more Relevance . Treatment of diffuse lesions of the arteries of the lower extremities is often reduced to primary amputation at the hip level, since the healing of trophic ulcers is not guaranteed during arterial reconstruction. Profundoplasty without distal bypass surgery can be considered an alternative method. The aim of this study is to compare the long-term results of distal shunting and isolated profundoplasty in patients with diffuse lesions of the lower limb arteries and trophic ischemic ulcers. Materials and Methods . The study included 86 patients with diffuse lesions of the lower limb arteries. There were 52 (60.4%) men and 34 (39.6%) women. The average age was 67.3 16.8 years. All patients had diffuse lesions of the arteries below the pupar ligament, the state of the lower leg arteries was 5-8.5 points on the Rutherford scale, in all cases there were trophic ulcers. Group 1 included 48 patients who underwent reconstruction of the leg arteries. Group 2 consisted of 38 individ...
Kreativnaya kardiologiya, 2015
Interactive CardioVascular and Thoracic Surgery, 2009
European Journal of Cardio-Thoracic Surgery, 2005
Objective: Operation for aortic recoarctation and/or residual hypoplastic arch represents a surgi... more Objective: Operation for aortic recoarctation and/or residual hypoplastic arch represents a surgical challenge because of surrounding scar tissue in the coarctation area, hazard of spinal cord ischemia due to aortic cross-clamping, laceration of the recurrent nerve, and the choice of the best approach. We demonstrate the results of 52 operations of an extra anatomically bypass technique via right thoracotomy approach without establishment of cardiopulmonary bypass. Methods: Since 1987, 52 patients underwent extra anatomically positioned ascendingdescending bypass grafting. Indication was aortic recoarctation with concomitant hypoplastic aortic arch (45 patients), atypical coarctation of aortic arch (2 patients), congenital anomalies of aortic arch (2 patients) and concomitant aortic coarctation and associated cardiac problems that required surgical repair (2 patient), infected stent-graft of descending aorta (1 patient). Mean age was 19.3 years. Systolic pressure gradients at rest ranged from 35 to 90 mmHg; upper extremity hypertension was present in all patients. Operative technique consisted of performing aorta ascending-descending bypass graft size 16 or 18 mm in diameter, via right thoracotomy (in 51 patient) or sternotomy (in 1 patient). Results: The mortality rate was 1.9% (1/52). Five patients returned to the operating room (in 3-5 days after operation) for a lymphorrhea complication. An arterial pressure gradient in the limbs was totally corrected. During a follow-up period of actually 79G54 months, no adverse event was noticed and antihypertensive medication was stopped in all patients. Conclusions: Ascending-to-descending aortic bypass via right thoracotomy is a safe and effective method for management complex (re-) coarctation and hypoplastic aortic arch.