In Moscow operation on implantation of a hypodermic defibrillator using the GE Healthcare angiograph is for the first time performed

2019: Carrying out operation on implantation of a hypodermic defibrillator using the GE Healthcare angiograph

On August 1, 2019 in the Moscow private clinic JSC Meditsina (clinic of the academician Roytberg) operation of hypodermic implantation of a defibrillator to the patient with ventricular arrhythmia, fibrillation of ventricles against the background of a hypertrophic cardiomyopathy and risk of sudden death from cardiac arrest was performed. It became known on August 5, 2019. Transaction is executed by team of the leading heart surgeons of JSC Meditsina (clinic of the academician Roytberg) under the leadership of Ardashev Andrey Vyacheslavovich and Kocharyan Armen Arturovich, with clinical support of professor Joachim Winter (Germany).

It became possible thanks to existence in JSC Meditsina of angiographic installation of the last generation Innova IGS 530 of production GE Healthcare which allows surgeons to receive images of the best quality using 3D technologies - modeling. Installation allows to execute a full range of interventions in any areas of a human body directed both to detection of diseases of vessels, and to their treatment.

Traditionally implantation of a defibrillator becomes via the right cameras of heart, passes through the three-leaved valve. In heart the electrode is entered that can lead to a haemo dynamic compromise and insolvency of the three-leaved valve. In JSC Meditsina to the patient performed operation which is minimum invasive, executed through a small section, and all system is introduced hypodermically. This technique as much as possible reduces risks of infectious and other complications, in comparison with a traditional method of implantation, told Andrey Vyacheslavovich Ardashev, the consultant of JSC Meditsina (clinic of the academician Roytberg) the doctor-aritmolog, MD

We always apply the advanced medical technologies, we use the best medical equipment. But we are proud of this transaction especially. Surgeons executed transaction after which the patient was written out from a hospital next day. Now we can save people from death as a result of sudden cardiac arrest using modern methods of prevention,

Ventricular fibrillation is the fast, irregular rhythm arising in heart ventricles. Such violation of a rhythm of heart is considered life-threatening as can lead to sudden cardiac arrest, and requires immediate recovery of a rhythm using a defibrillation - drawing high-energy electric discharge on heart that is not always possible. Therefore early diagnostics and prevention of high risk of sudden death from cardiac arrest is extremely important. As a rule, the patients having problems with a cardiovascular system are observed at cardiologists and accept medicinal therapy. Unfortunately, it does not guarantee absolute efficiency. Prevention using implantation of cardiodefibrillators is taken for granted - when the electrode is implanted endokardialno, i.e. implanted directly in heart. But there is a number of patients to whom the endokardialny method is not desirable. For example, it is small children, or people of low growth of a slender constitution. They grow up, or their build changes and, respectively, the geometry of heart and geometry of the device changes. It is also important for patients who have a big mass of a myocardium (cardiac muscle), at endokardialny placement of electrodes of power of a defibrillation can be insufficiently. The more the mass of muscular tissue, the is more difficult to make an effective defibrillation as capture of critical mass of a myocardium is necessary to recover a normal rhythm of heart. In such cases placement of electrodes over a cardiac muscle which actually imitates an outside defibrillation and meets necessary conditions is necessary.

The most significant risk factors of sudden deaths from cardiac arrest are presence of malignant ventricular arrhythmias and decrease in sokratitelny capability of the left ventricle. From ventricular arrhythmias are most dangerous fibrillation (trembling) of ventricles which cause a blood circulation stop. Also risk factors are: family anamnesis of a coronary heart trouble, advanced age, male, increase in level of the general cholesterol, lipoproteid of low density, arterial hypertension, smoking and diabetes and also abuse of alcohol.

Annually in the world about 17 million people die of cardiovascular diseases, and 25% of death occur on the mechanism of the sudden warm death (SWD). In this regard the problem of stratification of risk and prevention of ARIA is extremely relevant for domestic health care. In most cases (85%) development mechanisms of ARIA are ventricular takhiaritmiya – ventricular tachycardia and fibrillation of ventricles with the subsequent development of an asistoliya. Modern technologies give ample opportunities of use of the effective preventive measures directed to improvement of a situation.