Surgery, Cardiology and Cardiovascular Medicine, Anatomy, Neurology (clinical)
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Scopus Publications
Scopus Publications
Functional assessment of internal carotid artery tortuosity in patients with multifocal atherosclerosis O.I. Zagorulko, L.A. Medvedeva, O.V. Drakina, E.F. Dutikova, S.P. Baidin Pirogov Russian Journal of Surgery, 2024 The review is devoted to diagnosis and treatment of internal carotid artery tortuosity. The authors consider modern classification, epidemiology and diagnostic options using neuroimaging or ultrasound-assisted functional stress tests depending on medical history and complaints. In addition to standard Doppler ultrasound, rotational and orthostatic tests are advisable due to possible changes of local shape and hemodynamic parameters following body position changes, especially in patients with concomitant atherosclerotic stenosis. Thus, a personalized approach is especially important for treatment and diagnostics of internal carotid artery tortuosity.
Dynamic functional assessment of internal carotid artery tortuosity in patients with multifocal atherosclerosis L.A. Medvedeva, O.I. Zagorulko, E.R. Charchyan, O.V. Drakina, E.F. Dutikova Pirogov Russian Journal of Surgery, 2024 A personalized approach with attention to anamnesis and specific symptoms is necessary in patients with internal carotid artery tortuosity. Neuroimaging (especially before elective surgery) or functional stress tests following ultrasound of supra-aortic vessels may be necessary depending on medical history and complaints. In addition to standard Doppler ultrasound, these patients should undergo rotational and orthostatic transformation tests. We analyze changes in shape and hemodynamic parameters within the tortuosity area in various body positions. This is especially valuable for patients with concomitant carotid artery stenosis. The article presents a clinical case illustrating the importance of such approach.
HISTORICAL ASPECTS OF MITRAL VALVE PROSTHETICS WITH AUTOPERICARDIUM Darya A. Iaitskaia, Roman N. Komarov, Maxim I. Tkachev, Stanislav V. Chernyavskij, Olga V. Drakina, Ilya M. Vasalatii, Anton V. Tsaregorodtsev, Maxim O. Panchenko Complex Issues of Cardiovascular Diseases, 2024 Highlights This article describes not only the contribution of surgeons from different countries and the evolution of the method, but also the contribution of domestic specialists. The article makes us wonder whether mitral valve reconstruction with autopericardium is really a promising technique. Further study of the long-term results and improvement of the technique are necessary. AbstractMitral valve replacement with autologous pericardium is a new perspective method of treatment, which can be used for a wide range of mitral valve diseases when its reconstruction is not possible. Thanks to this method, there is no need for lifelong administration of anticoagulants, and optimal coaptation of the leaflets is provided. This review describes historical aspects of mitral valve replacement with autopericardium, mentions the first interventions, reflects the evolution of autopericardium mitral valve replacement technique.
Electrophoretically Co-Deposited Collagen–Lactoferrin Membranes with Enhanced Pro-Regenerative Properties for Oral Soft Tissue Regeneration Artem Antoshin, Mikhail Gostev, Yana Khristidis, Aliia Giliazova, Sergei Voloshin, Nataliia Blagushina, Olga Smirnova, Ekaterina Diachkova, Elena Istranova, Anna Usanova, Nikolai Solodov, Alexey Fayzullin, Elena Ivanova, Elena Sadchikova, Milena Noelia Vergara Bashkatova, Olga Drakina, Svetlana Tarasenko, Peter Timashev International Journal of Molecular Sciences, 2023 The quality of soft tissue defect regeneration after dental surgeries largely determines their final success. Collagen membranes have been proposed for the healing of such defects, but in some cases, they do not guarantee a sufficient volume of the regenerated tissue and vascularization. For this purpose, lactoferrin, a protein with natural pro-regenerative, anti-inflammatory, and pro-angiogenic activity, can be added to collagen. In this article, we used a semipermeable barrier-assisted electrophoretic deposition (SBA-EPD) method for the production of collagen–lactoferrin membranes. The membrane structure was studied by SEM, and its mechanical properties were shown. The lactoferrin release kinetics were shown by ELISA within 75 h. When tested in vitro, we demonstrated that the collagen–lactoferrin membranes significantly increased the proliferation of keratinocytes (HaCaT) and fibroblasts (977hTERT) compared to blank collagen membranes. In vivo, on the vestibuloplasty and free gingival graft harvesting models, we showed that collagen–lactoferrin membranes decreased the wound inflammation and increased the healing rates and regeneration quality. In some parameters, collagen–lactoferrin membranes outperformed not only blank collagen membranes, but also the commercial membrane Mucograft®. Thus, we proved that collagen–lactoferrin membranes produced by the SBA-EPD method may be a valuable alternative to commercially used membranes for soft tissue regeneration in the oral cavity.
Intervertebral Canals and Intracanal Ligaments as New Terms in Terminologia anatomica Kirill Zhandarov, Ekaterina Blinova, Egor Ogarev, Dmitry Sheptulin, Elizaveta Terekhina, Vladimir Telpukhov, Yuriy Vasil’ev, Mikhail Nelipa, Olesya Kytko, Valery Chilikov, Peter Panyushkin, Olga Drakina, Renata Meilanova, Artem Mirontsev, Denis Shimanovsky, Tatyana Bogoyavlenskaya, Sergey Dydykin, Vladimir Nikolenko, Artem Kashtanov, Vladimir Aliev, Natalia Kireeva, Yulianna Enina Diagnostics, 2023 This study addresses the cervical part of the vertebral column. Clinical pictures of dystrophic diseases of the cervical part of the vertebral column do not always correspond only to the morphological changes—they may be represented by connective tissue formation and nerve and vessel compression. To find out the possible reason, this morphometric study of the cervical part of the vertebral column in 40 cadavers was performed. CT scans were performed on 17 cadaveric material specimens. A total of 12 histological samples of connective tissue structures located in intervertebral canals (IC) were studied. One such formation, an intracanal ligament (IL) located in the IC, was found. Today, there is no term “intervertebral canal”, nor is there a detailed description of the intervertebral canal in the cervical part of the vertebral column. Cervical intervertebral canals make up five pairs in segments C2–C7. On cadavers, the IC lateral and medial apertures were 0.9–1.5 cm and 0.5–0.9 cm, correspondingly. According to our histological study, the connective tissue structures in the IC are ligaments—IL. According to the presence of these ligaments, ICs were classified into three types. Complete regional anatomy characterization of the IC of the cervical part of the vertebral column with a description of its constituent anatomical elements was provided. The findings demonstrate the need to include the terms “intervertebral canal” and “intervertebral ligament” in the Terminologia anatomica.
Predictors of chronic pelvic pain in female population O.I. Zagorulko, L.A. Medvedeva, O.V. Drakina, O.I. Loginova Russian Journal of Pain, 2023 Objective. To analyze predictors of chronic pelvic pain (CPP) in female population. Material and methods. We reviewed literature data on predictors of CPP and mechanisms of correlation in the PubMed and CyberLeninka databases. Results. CPP predictors can be divided into several categories: non-modifiable characteristics, individual mental characteristics, social factors, comorbidities. Among non-modifiable characteristics, female sex and age 30-50 years increase the risk of CPP. When analyzing mental characteristics in patients with CPP, we found a correlation of CPP with emotional lability, anxiety, depression and pain catastrophizing. Analysis of social factors is quite difficult, since most of them affect perception and chronization of pain indirectly and in conjunction with other factors. Concomitant pain syndromes, such as irritable bowel syndrome, primary dysmenorrhea and interstitial cystitis, are especially significant predictors of CPP. The role for cardiovascular reactivity and ovarian function is plausible but requires further consideration. Conclusion. Most CPP predictors are easy to be detected during analysis of history. Identification of CPP predictors may be important for diagnostic searching, rational choice of treatment and assessment of prognosis.
Tricuspid valve replacement with a mitral homograft: Surgical technique and immediate results R.N. Komarov, M.D. Nuzhdin, A.O. Simonyan, O.V. Drakina, A.V. Tsaregorodtsev Kardiologiya I Serdechno Sosudistaya Khirurgiya, 2023 The authors present 3 clinical cases of tricuspid valve replacement using a mitral homograft. Surgical technique of mitral homograft implantation is described in detail. For clarity, the article is supplemented with original illustrations. At the end of description of surgical technique, a short question-and-answer discussion is provided. The authors present early postoperative results. The debatable issues regarding the indications for this procedure and surgical technique itself are briefly analyzed. Although there are no long-term results of tricuspid valve replacement using a mitral homograft and immediate results are not systematized, we believe that mitral homograft is an excellent prosthesis. This procedure can improve survival and quality of life in certain groups of patients. Decision making on mitral homograft implantation should be performed individually, and this surgery cannot yet be used routinely due to some difficulties described in the article.
Anatomy of the mitral valve during autopsy compared to the data of lifetime echocardiography R.N. Komarov, S.S. Dydykin, S.V. Cherniavskii, M.D. Nuzhdin, O.V. Drakina, N.M. Babakulova, I.M. Vasalatii Russian Journal of Operative Surgery and Clinical Anatomy, 2023 Autopericardial reconstruction of heart valves makes it possible to restore normal hemodynamic parameters using patient’s tissue, which do not cause rejection reactions and do not require constant intake of anticoagulants. Knowledge of the mitral valve anatomy and math modeling are needed to perform a personalized reconstruction. Universal formulas for the structure of the mitral valve can be derived by echocardiography. The paper compares transthoracic echocardiography and the anatomy of the mitral valve during autopsy. The paper compares transthoracic echocardiography and the anatomy of the mitral valve during autopsy. Math modeling of the autopericardial leaflets and primary (marginal) chords is described. Objective. To evaluate comparability of the morphometric results obtained by echocardiography and autopsy. Material and methods. 12 hearts after autopsy were analyzed by calculating the size and relative position of the valvular structures, and 20 transthoracic echocardiographic measurements were made on the Philips CX50 ultrasound machine. Exclusion criteria: heart disease, primarily mitral valve pathology, as well as previous cardiac surgery. Morphometric data were analyzed by statistical software platform IBM SPSS Statistics 23.0. The Kolmogorov—Smirnov test, the independent sample t-test, the Mann—Whitney U test, the Pearson correlation coefficient, Spearman’s rank correlation coefficient and the linear regression were used. Results. On the basis of EchoCG data and anatomical studies, mathematical models of the mitral valve of the heart are presented and universal formulas are obtained for calculating the size of the mitral valve cusps and their primary chords with a known diameter of the mitral valve. Comparative characteristics of echocardiography and anatomical study of the mitral valve are given. Conclusion. Two-dimensional echocardiography is used for studying the anatomy of the mitral valve. Ultrasound visualization of the diameter of the mitral valve and the length of its anterior and posterior cusps significantly correlates with their true sizes. The method finds limited application in studying the height of the valves and the length of the primary chords. However with suitable improvement of accuracy it can be used.
MITRAL HOMOGRAFT IN TRICUSPID POSITION: INDICATIONS FOR IMPLANTATION AND SURGICAL TECHNIQUE Roman N. Komarov, Mikhail D. Nuzhdin, Vyacheslav A. Belov, Stanislav V. Chernyavsky, Alisher M. Ismailbayev, Olga V. Drakina, Anton V. Tsaregorodtsev, Lusine R. Baziyants Complex Issues of Cardiovascular Diseases, 2023 HighlightsThe article presents the latest data on the techniques of implantation of the mitral homograft in the tricuspid position, and identifies groups of patients who are best suited for this method. Moreover, the article describes the evolution of this type of replacement, and highlights that many surgical techniques, although justified, require further study to show demonstrate their advantages. AbstractDespite the general trend in cardiac surgery towards valve-preserving interventions, valve replacements remain relevant, and the search for the perfect prosthetic valve continues. Many believe that tricuspid valve replacement using a mitral homograft can be the method of choice in certain situations. The analysis of the studies found in the PubMed database led the authors to the following conclusions: most of the data on the use of this technique in patients with infective endocarditis (IE), other indications are congenital heart disease (CHD) and rheumatic heart disease. Patients with IE who have undergone tricuspid valve replacement using a mitral homograft have good medium-term prospects, and respond well to medical treatment of recurrent IE. The mitral homograft in the tricuspid position remains intact even after prosthetic endocarditis. In this regard, it is possible to perform reconstructive intervention in case of prosthetic valve dysfunction without the need for repeated replacement. Such interventions are relevant for patients with growing heart for whom annuloplasty at the first stage of surgery is undesirable. Moreover, it is also cost-effective due to the high cost and low availability of homografts. The possibility of repeated tricuspid valve-in-valve replacement is important for patients who may not survive open surgery. To date, there are not enough long-term and short-term data on using a mitral homograft for tricuspid valve replacement, however, it can be assumed that the results of this technique will be positive provided that the appropriate implantation technique and strict patient selection are ensured. Many authors have come to the conclusion that the optimal homograft implantation technique includes sewing of the graft`s papillary muscles into the wall of the myocardium of the right ventricle (RV), fixating them on the outer surface of the RV, anatomical positioning of the homograft (anterior leaflet faces towards the IVS), and the use of an annuloplasty ring.
HISTORICAL ASPECTS OF AORTIC VALVE REPLACEMENT USING AUTOLOGOUS PERICARDIUM: DO WE KNOW EVERYTHING? R. N. Komarov, M. I. Tkachev, V. A. Savina, S. V. Chernyavsky, O. V. Drakina, A. M. Ismailbayev, M. S. Lenkovets, V. K. Noginov Complex Issues of Cardiovascular Diseases, 2023 Highlights. The article describes the contribution of foreign and Russian surgeons to the development of aortic valve replacement using autologous tissue, and presents the evolution of the technique. The authors tried to answer the question whether the Japanese professor S. Ozaki actually developed something new or the discovery was already made 40 years ago. At the end of the article, the technique developed by a Russian cardiac surgeon is presented, casting doubt on the use of templates in this procedure.Abstract. Aortic valve replacement using autologous pericardium (neocuspidalization) is becoming an increasingly attractive option that can be applied to a wide range of aortic valve diseases. This technique avoids the need for lifelong administration of anticoagulant drugs, and provides the maximum effective orifice area, resulting in a low transvalvular gradient. The new technique, introduced by Shigeyuki Ozaki, has made the procedure more reproducible with promising medium- and longterm results. But is Ozaki the predecessor of this technique or is “all new is well forgotten old”? This review focuses on the historical aspects of the development of neocuspidalization of the aortic valve using autologous pericardium, the first interventions for valve reconstruction are mentioned, the evolution in the technique of preparation and fixation of the leaflets is reflected.
Anatomy of the mitral valve in the reconstructive surgery R.N. Komarov, V.N. Nikolenko, S.S. Dydykin, S.V. Cherniavskii, O.V. Drakina, M.V. Nelipa, O.V. Kytko, I.M. Vasalatii, S.P. Baydin, A.O. Feldman, A.E. Cherepanova, A.B. Alekseev, A.T. Nikitina, F.R. Gulmagomedova Russian Journal of Operative Surgery and Clinical Anatomy, 2022
Multifunctional video endoscopic surgery training simulator for students, residents and surgeons O.V. Drakina, Yu.L. Vasil’ev, S.S. Dydykin, P.V. Kryucko, O.V. Kytko, R.J. Meilanova, V.V. Chilikov, A.K. Begunova, I.I. Nadelyaeva, G.V. Brykin, O.S. Vavilova, M.V. Gerasimenko, E.A. Lidzhieva, M.N. Vergara Bashkatova, A.D. Kashtanov, E.V. Molotok Russian Journal of Operative Surgery and Clinical Anatomy, 2022
