DOMESTIC EXPLANTS BASEKS IN RECONSTRUCTIVE SURGERY OF AORTA AND MAGISTRAL ARTERIES

Abstract

Purpose. The use of explants in cardiovascular surgery is often accompanied by infectious, thrombotic, hemorrhagic complications and the most severe complication of postoperative period represents the infection of the explants itself, which develops at a frequency of 1.5 to 6 % followed by a mortality rate of 75–100 %. Thrombosis of the explants after surgery occur with a frequency of 6 to 42 %. Materials and methods. From 1996 to 2015, explants of BASEKS were used in 3 600 patients. Implants of BASEKS were used in 75 patients with aortic valve malformation in combination with an aneurysm of the ascending aorta and prosthetic endocarditis and in 1 944 patients with reconstruction of the aorta and arteries. Results. Bacteriological studies have demonstrated a wide range of antimicrobial action of the modifying components covering the explant and patches. The most promising results were obtained for micro-organisms which most commonly caused infections of these explants. All the sample explants had antimicrobial property and the zone of lysis around these explants were maintained for a longer time (up to 30 days or more). The residual anti-microbial explants after surgery were studied in vitro in 5 patients who died from peritonitis, heart, lungs and kidney failure. Explants after sampling were placed on growth media seeded with clinical strains of microorganisms. Within 12–24 hours, zones (15–18 mm) that caused the delay of the growth of microorganisms were formed around the studied fragments, confirming the preservation of the residual antimicrobial activity of the explants after implantation. During the period of follow-up, in 1.9 % of the patients in immediate postoperative period and in 4.1 % of patients in later postoperative period occurred thrombosis of the explants. Surface festering of the postoperative wound was observed in 155 (4.3 %) patients, deep festering – in 51 (1.4 %), 98 (2.7 %) patients succumbed to postoperative complications. Conclusion. The explants and patches of BASEKS which is antimicrobial, thromb-resistant and impermeable, could be widely used in cardiovascular surgery.