Authors
Muzychin A.L.1, Khavandeev M.L.2, Moshkin S.V.1, Zalyubovskaya L.V.1, Gitelzon E.A.3, Faibushevich A.G.3
1 RCH named after M.I. Kalinina, Donetsk
2 Institute of Emergency and Reconstructive Surgery named after. V.K. Gusak, Donetsk
3 Russian Peoples’ Friendship University named after Patrice Lumumba, Moscow
Abstract
Rationale: the use of various efferent methods has proven positive in the complex treatment of patients with cardiac surgical pathology. The article presents a method for performing filtration plasmapheresis during during cardiopulmonary bypass surgery in patients with infective endocarditis.
Objective: to evaluate the effectiveness of the developed method of intraoperative plasmapheresis during cardiopulmonary bypass in patients with infective endocarditis.
Methods: the study materials describe a method for integrating a plasma filter directly into the circuit of a heart – lung machine without the use of additional equipment for plasmapheresis. The study of this method was carried out on the basis of the Department of Cardio – and X – ray Vascular Surgery of the State Budgetary Institution of the DPR “Republic Clinical Hospital named after M.I. Kalinin”, Donetsk in the period from 2014 to 2024. The study involved 96 patients who were divided into two groups (52 and 44 patients, respectively). In Group I, the procedure of intraoperative plasmapheresis was performed. In Group II, the plasmapheresis procedure was not performed. Patients underwent the following surgical interventions: aortic valve replacement (AVR) – 28 (29.17%), mitral valve replacement (MVR) – 30 (31.25%), tricuspid valve replacement (TVR) – 33 (34.38%), replacement of aortic and mitral valves – 5 (5.2%).
Conclusion: intraoperative plasmapheresis helps improve exit from cardiopulmonary bypass by independently restoring the rhythm without the use of defibrillation and reducing the need for the use of adrenergic agonists to normalize blood pressure.
The use of the method demonstrates an improvement in the course of the postoperative period, manifested in a decrease in cardiotonic support, early normalization of body temperature and laboratory parameters, namely: the absolute number of leukocytes, relative to the content of band and segmented leukocytes, erythrocyte sedimentation rate, C – reactive protein and leukocyte intoxication index.
Keywords: infective endocarditis, plasmapheresis, artificial circulation.
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