P310. Staged Operations on the Thoracic and Abdominal Part of the Aorta in Case of Penetrating Shrapnel Injuries
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Lviv Clinical Regional Hospital
Lviv
Ukraine - Contact Me
CURRICULUM VITAE
PERSONAL INFORMATION
First name: Dmytro
Last name: Beshley, MD, MMed
Birthday: November 5, 1983
Citizenship: Ukraine
Address: Trakt Hlynyanskyy ST, 153/120, Lviv, 79076 Ukraine
Telephone: +38 (063) 2288625
E-mail: [email protected]
PRESENT POSITION
- 08/2010 – present Cardiac surgeon,
Department of Cardiac Surgery,
Lviv Regional Clinical Hospital, Lviv, Ukraine
- 09/2015 – present PhD-student,
Department of General Surgery #2
Danylo Halytsky Lviv National Medical University
QUALIFICATIONS
- Degree Name: Master of Medicine in Cardiac Surgery
- Degree Type: Masters
- Degree Duration: 4
CLINICAL INTEREST
- mitral valve repair surgery specifically minimally invasive approaches
- aortic valve repair
- valve sparing root replacement
- transcatheter valve procedures
- aortic aneurysm, thoracic endovascular aneurysm repair
- coronary artery bypass
RESEARCH INTEREST
- minimally invasive surgery of aortic, mitral and tricuspid valves
MEMBERSHIP
- The European Association for Cardio-Thoracic Surgery (EACTS);
- Association of French-Ukrainian Cooperation in Public Health and Pharmacy (ASFUDS)
SCIENTIFIC ACTIVITIES
Author of 30 scientific articles.
HONORS AND AWARDS
- Lviv Regional State Administration scholarship, "For sacrificial work", 2016
- Order of Bohdan Khmelnytsky III degree, Decree of the President of Ukraine No. 257/2016 of June 17, 2016.
- State scholarship, Decree of the President of Ukraine No. 457/2017 of December 29, 2017.
- The honors for professionalism and mercy "The Order of Saint Panteleimon", 2018
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Objective: to analyze the early and mid-term results of urgent surgical procedures for shrapnell penetrating injuries of the thoracic and abdominal cavities with damage to the thoracic or abdominal part of the aorta.
To analyze the early results of endoprosthesis of the descending thoracic aorta in case of shrapnels pseudoaneurysms of the thoracic aorta.
Methods: patients with shrapnel penetrating wounds of the thoracic and abdominal cavity with damage to the thoracic or abdominal sections of the aorta, with profuse bleeding were studied in detail. Patients were brought to the operating room in the first two hours from the moment of the injury. Urgent surgical procedures^ thoracotomies and laparotomies were performed in patients with ongoing bleeding with an attempt to sew up damage to the thoracic or abdominal aorta. Mainly suturing of damage to the aorta on the lateral impression was performed with the help of U-shaped sutures on teflon pads. If necessary, the aorta was wrapped externally with a vascular prosthesis to achieve stable hemostasis. REBOA endovascular balloon was used during operations for damage to the abdominal part of the aorta to reduce bleeding and centralize blood circulation. Urgent thoracotomies and laparotomies were performed only under the condition of relative stabilization of the patient's condition and adequate replenishment of the volume of circulating blood.
Results: intraoperative and early postoperative mortality (during first 6 hours) was 59% in patients with srapnel injuries of the thoracic or abdominal part of the aorta who underwent emergency surgery. Patients with small aortic injuries (2-3 mm) or tangential injuries made up the majority of patients who successfully underwent surgical interventions. Among the patients who successfully underwent life-saving operations, 25% had complications in the form of pseudoaneurysms of the aorta and required endoprosthesis of the aorta in a timely manner.
Conclusions: gunshot penetrating shrapnel injuries with damage to the thoracic or abdominal aorta are life-threatening injuries and are accompanied by high mortality. Emergency thoracotomies and laparotomies with subsequent suturing of aortic injuries enable about 41% of patients to survive. In the future, patients need dynamic monitoring for 6 months for the purpose of timely diagnosis and hybrid or endovascular treatment of pseudoaneurysms of the aorta.
Authors
DMYTRO BESHLEY (1), Andriy Sobko (2), Roman Sobko (3), Uliana Pidvalna (4)
Institutions
(1) Lviv Regional Clinical Hospital, Mobile Military Hospital, Ukrainian-Polish Heart Center Lviv, Lviv, Ukraine, (2) MD., Surgeon, Lviv, --None--, (3) MD., Anestesiologist, Lviv, Ukraine, (4) MD., Radiologist, Lviv, Ukraine
To analyze the early results of endoprosthesis of the descending thoracic aorta in case of shrapnels pseudoaneurysms of the thoracic aorta.
Methods: patients with shrapnel penetrating wounds of the thoracic and abdominal cavity with damage to the thoracic or abdominal sections of the aorta, with profuse bleeding were studied in detail. Patients were brought to the operating room in the first two hours from the moment of the injury. Urgent surgical procedures^ thoracotomies and laparotomies were performed in patients with ongoing bleeding with an attempt to sew up damage to the thoracic or abdominal aorta. Mainly suturing of damage to the aorta on the lateral impression was performed with the help of U-shaped sutures on teflon pads. If necessary, the aorta was wrapped externally with a vascular prosthesis to achieve stable hemostasis. REBOA endovascular balloon was used during operations for damage to the abdominal part of the aorta to reduce bleeding and centralize blood circulation. Urgent thoracotomies and laparotomies were performed only under the condition of relative stabilization of the patient's condition and adequate replenishment of the volume of circulating blood.
Results: intraoperative and early postoperative mortality (during first 6 hours) was 59% in patients with srapnel injuries of the thoracic or abdominal part of the aorta who underwent emergency surgery. Patients with small aortic injuries (2-3 mm) or tangential injuries made up the majority of patients who successfully underwent surgical interventions. Among the patients who successfully underwent life-saving operations, 25% had complications in the form of pseudoaneurysms of the aorta and required endoprosthesis of the aorta in a timely manner.
Conclusions: gunshot penetrating shrapnel injuries with damage to the thoracic or abdominal aorta are life-threatening injuries and are accompanied by high mortality. Emergency thoracotomies and laparotomies with subsequent suturing of aortic injuries enable about 41% of patients to survive. In the future, patients need dynamic monitoring for 6 months for the purpose of timely diagnosis and hybrid or endovascular treatment of pseudoaneurysms of the aorta.
Authors
DMYTRO BESHLEY (1), Andriy Sobko (2), Roman Sobko (3), Uliana Pidvalna (4)
Institutions
(1) Lviv Regional Clinical Hospital, Mobile Military Hospital, Ukrainian-Polish Heart Center Lviv, Lviv, Ukraine, (2) MD., Surgeon, Lviv, --None--, (3) MD., Anestesiologist, Lviv, Ukraine, (4) MD., Radiologist, Lviv, Ukraine
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.