A two-part article reviews and discusses the eponymous names of topographic landmarks and anatomical structures of a normally formed heart, covering the first written evidence of the use of anatomical terms Galen in the 2nd century up to the heart conduction system described in the 20th century and V.P. Vorobyov’s discovery of the cardiac plexus. A total of 90 eponyms were identified, including: 1) 6 pericardial eponyms; 2) 19 atrial eponyms; 3) 15 ventricular eponyms; 4) 28 eponyms of the conducting system and nerves of the heart; 5) 22 eponyms of the great arteries and the coronary arteries. The origin of several eponyms dates back to 2nd century, namely Galen's orifice and duct, Leonardo (da Vinci) ostium, valve and cord; Sinev-Crymski triangle, Tandler's trabecula, Hochstetter's septum). The rise of using eponyms for anatomical structures of the heart started from the 16th century (Leonardo (da Vinci) cord, tubercle of Lower, etc.) and was followed in 17th (nodules of Aranzio, Eustachian valve, etc.), the 18th (sinuses of Valsalva, Vieussens valve, Haller's horns, Thebesian veins, etc.), the 19th (Albini nodules, Haller's cavity, Henle space, canal of Cuvier, Rathke bundles, etc.), the 20th (Aschoff-Tawara node, Wenckebach’s bundle, triangle of Koch, etc.) centuries. Some eponyms are used erroneously (e.g. Botallo did not describe the ductus arteriosus, but redescribed the foramen ovale; the oblique pericardial sinus is mistakenly called Haller's sinus, and the atrioventricular septum is called Leonrado (Da Vinci) septum). To designate some anatomical structures double eponyms are used (Aranzio-Bianchi nodules, Worobiew-Marshall fold, Vieussens-Thebesian vessels, His-Tawara bundle, Eustachian-Sylvian’s valve, His-Flack’s node, etc.). A brief biography of famous eponymous surgeons gives insight and background to their work and professional achievements. The identified eponyms reflect the history of not only anatomy, but also medicine in general. For example, a series of discoveries of the structures of the heart conduction system in the early 20th century resultant from a switch to the morphological and pathomorphological concepts exploring heart function and associated diseases from the perspectives of the physiology and pathophysiology. Part 2 reviews the eponyms of the human heart conduction system, nerves, great vessels and coronary arteries.

Background: Laparotomic access is considered the standard surgical access in patients with abdominal aortic aneurysms and Leriche syndrome. To minimize surgical trauma and improve treatment outcomes, various minimally invasive approaches have been developed and proposed. Today, there are no randomized clinical studies comparing minimally invasive approaches in the medical literature. Superiority and inferiority of different surgical access to the abdominal aorta remain relevant for cardiothoracic surgery.

Aim: To evaluate the effectiveness of robot-assisted and minilaparotomy access approaches in patients with abdominal aortic disease.

Methods: The outcomes of patients with abdominal aortic disease who underwent surgical treatment using minilaparotomic access (n=71) and robot-assisted access (n=31) were assessed.

Results: Both groups were comparable at baseline, but differed significantly in the incidence of peri- and postoperative complications, surgery duration, conversion rate, bleeding and intraoperative blood loss. Conclusion: The mean surgery duration was significantly lower in the robot-assisted access group compared to the minilaparotomy access group (143.2 vs. 268 min). Complications were determined in 10 patients (32.2%) in the robot-assisted access group versus 3 patients (4.2%) in the minilaparotomy access group. Conversion (9.6%) was observed only in the robot-assisted group. The mean volume of intraoperative blood loss was 475.5 mL and 970 mL in the robot-assisted access group and minilaparotomy access group. is superior in terms of reducing surgery duration, infectious complications, and intraoperative blood loss. However, the use of minilaparotomy is more effective in terms of the absence of conversion.

Aim: To assess the immediate and long-term results of patients undergoing off-pump coronary artery bypass grafting through left antero-lateral thoracotomy.

Methods: Medical records of 1,178 patients referred to elective cardiac surgery at the Federal Center for High Medical Technologies in the period from September 2012 to June 2023 were retrospectively reviewed. All patients underwent off-pump CABG through left antero-lateral thoracotomy. Men (n=946; 80.3%) prevailed in the study population. The mean age of patients was 64.3±15.4 years. A large proportion of patients suffered from class 2 (n=387; 32.8%) and class 3 (n=691; 58.6%) angina. A positive history of postinfarction cardiosclerosis was detected in 694 (66.2%) patients. Almost half of them were present with polyvascular diseases, including 182 (15,4%) patients with atherosclerotic lesions of the brachiocephalic arteries and 161 (13,6%) patients with peripheral artery disease and renal artery stenosis. 627 (53.2%) patients underwent hybrid procedures. Subclavian artery revascularization was performed in 13 (1.1%) patients. All the patients received a risk stratification based on the EuroSCORE II (2.2±1.1%). Early mortality, postoperative complications, and mid-term outcomes were assessed.

Results: All patients (1,178 patients) underwent off-pump CABG through left antero-lateral thoracotomy. Of them, 627 patients underwent CABG as a stage of hybrid procedure. Four (0.3%) patients required conversion to full sternotomy. The mean length of stay in the ICU was 1.1 days. The mean lengths of the in-hospital stay – 5.9 days. Thirteen (1.1%) patients had early postoperative bleeding that required re-exploration. Twentynine (2,5%) patients had atrial fibrillation treated with antiarrhythmic drugs. Superficial incisional infection occurred in 8 (0.7%) patients. In-hospital mortality was 0.7% (n=8). The mid-term follow-up period was up to 56±7 months. 161 patients (13.6%) were followed up. Elective percutaneous coronary intervention was performed in 15 (9.3%) patients. None of the patients underwent CABG. Three (1.8%) patients suffered from stroke, 6 (3.7%) – from myocardial infarction. Five (3.1%) patients died.

Conclusion: Off-pump coronary artery bypass grafting through left antero-lateral thoracotomy is associated with favorable immediate and long-term outcomes in patients with coronary artery disease undergoing isolated LAD revascularization or hybrid procedure for multivessel or polyvascular diseases.

Aim: To assess the immediate and mid-term outcomes of transapical and transfemoral aortic valve replacement using polymeric heart valve MedLAB CT.

Methods: A total of 319 patients with aortic valve disease admitted to the Federal Center for Cardiovascular Surgery (Penza) for elective cardiac surgery were enrolled in a prospective single-center study. The mean age of the patients was 73.3±4 years. All recruited patients were evaluated as high and medium risk for cardiac surgery with the mean EuroSCORE II of 6.27%. All surgeries were performed in a hybrid operating room under combined endotracheal anesthesia. The size of the valves was selected by the surgeon based on EchoCG findings, CT images of the aortic root, and intraoperative aortography. The endpoints were death from any cause and clinically significant cerebral stroke. Hemodynamic parameters were assessed according to echocardiography: the mean AV gradient, the effective orifice area, the severity of postoperative regurgitation.

Results: A total of 450 transapical and 8 transfemoral aortic valve replacement using polymeric heart valve MedLAB CT were performed. 29 (6%) patients died in the in-hospital period. Five (1%) patients had stroke. There were no cases of myocardial infarction. Acute kidney injury was diagnosed in eight (2%) patients. Eleven (2.4%) patients required pacemaker implantation. There were no cases of clinically significant aortic regurgitation in the early postoperative period. Four patients required repeat open aortic valve surgery within the same hospitalization. The mean AV gradient following surgery was 5.55±2.24, the peak – 11.29±4.46 mmHg. The effective orifice area was 2.27±0.60 cm². 80 patients died within the 8-years follow-up period. The mortality rate was 18.3% and the survival rate was 71.3% within 84 months.

Conclusion: The safety and effectiveness of the MedLAB CT polymeric heart valve prosthesis with PTFE leaflets are not inferior, but even superior in terms of several parameters to biological TAVR. TAVR via transapical and transfemoral access using MedLAB CT is a safe and effective procedure with favorable immediate and mid-term outcomes.

Aortic valve neocuspidization (split replacement of the leaflets) has gained wide popularity after the Japanese surgeon Shigeyuki Ozaki had developed an original method and special instruments. However, there is a number of other methods of neocuspidization. Many medical centers have yielded experience in neocuspidization for a wide range of indications as aortic stenosis, aortic regurgitation, infective endocarditis, congenital defect. Especially, this method is useful for the patients with the narrow aortic annulus. Neocuspidization is feasible as for the elderly and senile, as for the young and even children. Aortic valve anatomy may vary.

Early results of neocuspidization are associated with better hemodynamics than the biological or mechanical prostheses. The mid-term follow-up showed low mortality, low rates of structural degeneration, recurrent or new aortic regurgitation, and reoperations.

Due to the accumulated experience, aortic valve neocuspidization is regarded as an alternative to conventional aortic valve replacement with a biological or mechanical prosthesis. However, a lack of longterm results prevents us from recommending of neocuspidization as a method of choice so far.

Transvenous lead extraction is considered a first-line technique due to low rate of postoperative complications and mortality. Despite its traumatic nature, open chest lead extraction remains the most effective method allowing removing vegetations of large sizes and any location, as well as, performing simultaneous surgery for valvular and non-valvular heart disease. Surgical approach is associated with low risks of thromboembolic complications. The literature review discusses the outcomes of the open chest lead extraction and the structure of complications. Existing approaches, accesses and surgical techniques are highlighted.

Current evidence suggests that endovascular treatment of aortic dissection is an effective treatment for acute type B aortic dissection enabling the prevention of malperfusion syndrome and promoting further aortic remodeling. However, randomized clinical trials with long-term follow-up comparing open surgery and thoracic endovascular aortic repair are required to determine the optimal treatment strategy for chronic type B aortic dissection. Abstract Surgical treatment strategies for type A aortic dissection are well-studied and defined. The optimal treatment for acute type B dissection is still a matter of debate. There is ongoing discussion within cardiothoracic society surrounding the management of chronic type B aortic dissection. Open-heart surgery versus thoracic endovascular aortic repair? Open-heart surgery has been revolutionized by minimally invasive procedures, which have gained particular popularity over the past decade. Current evidence suggests that endovascular treatment of aortic dissection is an effective treatment for acute type B aortic dissection enabling the prevention of malperfusion syndrome and promoting further aortic remodeling. However, randomized clinical trials with long-term follow-up comparing open surgery and thoracic endovascular aortic repair are required to determine the optimal treatment strategy for chronic type B aortic dissection. Thus, the optimal treatment strategy for chronic type B aortic dissection needs to be defined, and to date there are no any firm recommendations suggesting the superiority of a specific approach. This review is aimed at summarizing existing evidences on the role of open-heart surgery in the treatment of type B aortic dissections. The literature search was performed using medical databases (Medline, Scopus, Google Scholar).

Median sternotomy is known to be an optimal access providing excellent exposure of the root, ascending segment, and aortic arch. However, extended access for optimal visualization is required in case of simultaneous intervention on the descending thoracic aorta.

We present our clinical case of successful simultaneous surgical treatment of aortic valve disease and descending thoracic aortic aneurysm using L-shaped shaped.