Work number - P 10 FILED
Authors:
1. TODUROV Borys Mykhailovych – Doctor of Medical Sciences, Professor, associate fellow of the National Academy of Medical Sciences of Ukraine, Chief Executive Officer of “Heart Institute the Ministry of Health of Ukraine”, Head of Cardiac Surgery, X-ray Endovascular and Extracorporeal Technology Department at P.L. Shupyk National Healthcare University of Ukraine.
2. KOVTUN Havrylo Ihorovych – Candidate of Medical Sciences, Head of Myocardial Pathology and Organ and Tissue Transplantation Unit at “Heart Institute the Ministry of Health of Ukraine”.
3. LOSKUTOV Oleh Anatoliiovych ̶ Doctor of Medical Sciences, Professor, anesthesiologist of Anesthesiology Unit at State Institution “Heart Institute the Ministry of Health of Ukraine”, Head of Anesthesiology and Intensive Care Department at P.L. Shupyk National Healthcare University of Ukraine,
4. SUDAKEVYCH Serhii Mykolaiovych – Candidate of Medical Sciences, Head of Anesthesiology and Extracorporeal Treatment Unit at State Institution “Heart Institute the Ministry of Health of Ukraine”, assistant professor of Cardiac Surgery, X-ray Endovascular and Extracorporeal Technology Department at P.L. Shupyk National Healthcare University of Ukraine.
5. KUZMYCH Ihor Mykolaiovych – Head of Adult Intensive Care Unit at “Heart Institute the Ministry of Health of Ukraine”, Distinguished Physician in Ukraine.
6. GONCHARENKO Mykola Vasylovych – anesthesiologist of "Heart Institute the Ministry of Health of Ukraine”, Honored Doctor of Ukraine;.
7. ZELENCHUK Oleg Valeriiovych - Candidate of Medical Sciences, Cardiovascular Surgeon of the Heart Institute the Ministry of Health of Ukraine. , Associate Professor of the Department of Cardiac Surgery, X-ray Endovascular and Extracorporeal Technologies of the Shupyk National University of Health of Ukraine
8. SAMCHUK Oleh Olehovych – General Director of the Municipal Non-Profit Enterprise "Lviv Territorial Medical Association "Multidisciplinary Clinical Hospital of Intensive Care and Emergency Medical Care",Philosophy Doctor, Assistant Professor of the Department of Surgery and Transplantology of the Faculty of Internal Medicine of Danylo Halytsky Lviv National Medical University.
Based on the results of this research, the efficient direction in surgical treatment of patients with terminal-stage HF on the waiting list due to DCMP, which provides significant increase of survival time and life quality for this patient population, has been developed and scientifically established for the first time in Ukraine.
The war changed the development of transplantology in Ukraine. The closure of the airspace, the impossibility of using medical aviation, the impossibility of implanting mechanical means of blood circulation support, the impossibility of carrying out transplants abroad, restrictions on the movement of both patients and doctors created a problem in the implementation of transplant assistance, especially in the regions located in the front-line zones. A new group of patients has appeared - military personnel who, during their service, received a disease that requires treatment by the method of transplantation. Thanks to changes in the legislation by adopting a number of resolutions, it became possible to carry out transplantation in wartime. New algorithms of interaction between transplant centers were developed, which made it possible to carry out transplants in different regions of Ukraine. The improvement of methods of conservation and transportation of the donor heart, due to the increase of ischemic time, made it possible to expand the possibilities of transplant assistance. The set of implemented measures directly affects the improvement of the country's defense capability.
This research is the first in Ukraine to present comparative assessment of various LV remodeling options and report on practical implementation of heart transplantation method.
In this research, the most common typical myocardial pathological changes in patients with DCMP are identified and described. Based on the analysis of correlation between primary morpho-histological changes of cardiomyocytes and myocardial contractility, the leading pathohistological changes in the heart muscle, influencing the low cardiac output development, have been identified.
This research is also the first to report the result of comparative efficiency analysis of various LV surgical remodeling options in patients with terminal-stage HF on the waiting list for HT conducted based on the intracardiac hemodynamic study.
The short-term and long-term outcomes of new surgical interventions – geometric reconstruction of the left ventricle and the heart transplantation in terminal-stage chronic heart failure – have been analyzed as part of this research for the first time in Ukraine.
The authors have developed and implemented new cardiac protection approaches and created the comprehensive system of interventions aimed at increasing the myocardial resiliency to ischemic effects during cardiac surgeries and the heart transplantation. This research is the first to propose novel antitheological support methods to be used in this patient population, which are different from the previous approaches in their pathogenic rationale and utilization of the most appropriate anesthesia patterns to prevent hemodynamic disorders and inhibit oxidative stress severity.
Based on the results of this research, the efficient method for surgical treatment of patients with chronic cardiac decompensation (NYHA III – IV) has been developed.
For the first time in Ukraine, the strategy of accompanying pregnant women with myocardial pathology and reduced contractility of the left ventricle has been scientifically substantiated and implemented into clinical practice; defined methods of treatment of such patients, observation periods, indications for early termination of pregnancy in order to prevent the development of circulatory decompensation, as well as indications for heart transplantation in such patients; developed clinical routes for such patients and coordinated with heart transplant centers in case of need for transplantation in the postpartum period.
For the first time in Ukraine, the authors performed the “Batista procedure” and heart transplantation surgeries in patients with terminal-stage heart failure. The authors also report on the level of echocardiographic changes during post-surgery period in this patient population.
Number of publications: 672 papers, including 4 monographs, 4 textbooks, 6 training manuals and 583 articles (including 68 articles in foreign journals). The total number of citations of the authors’ publications related to this research is 141 (according to Scopus database) with h-index = 3 and 439 (according to Google Scholar database) with h-index = 7. The authors have been granted 75 Ukrainian patents for this invention.
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