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Left Ventricular Aneurysm Surgery

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A heart aneurysm is a serious illness that causes impairment of the contractile activity of the affected area of the heart muscle. Most often such pathology develops in the wall of the left ventricle of the heart. The disease more often affects men over the age of 40. Aneurysm detected in the heart grows only up to a certain size, but always requires surgical treatment.

Treatment for left ventricular aneurysm

Today physicians cope with heart aneurysms only by surgery. This is the only effective method that can completely cure a patient. Medication therapy is only used to temporarily improve the condition of patients with left ventricular aneurysms. If a patient is diagnosed with a left ventricular aneurysm, urgent surgical treatment is prescribed in the presence of the following indications:

  • Severe heart rhythm abnormalities
  • Formation of a blood clot in the aneurysm
  • Rapidly developing heart failure
  • Aneurysm rupture

Surgical treatment of acute and subacute heart aneurysms is indicated in the rapid progression of heart failure and the threat of aneurysmatic sac rupture. In chronic cardiac aneurysm, surgery is performed to prevent thromboembolic complications and for myocardial revascularization.

As a palliative intervention, strengthening of the aneurysm wall with polymeric materials is resorted to. Radical operations include ventricular aneurysm resection (if necessary – with subsequent reconstruction of the myocardial wall).

How is the surgical treatment carried out?

During this procedure, the patient’s chest is opened and the blood flow through the heart is stopped. A special device is attached to the main vessels, which continues to maintain the pumping function while the heart remains inactive. Only then a surgeon removes the aneurysm. Vascular bypass is also performed, if necessary. After a cardiac aneurysm is excised, the treatment process is not over. After the operation, it is necessary to stay under the supervision of healthcare professionals, because there is a risk of complications.

In a post-traumatic aneurysm of the heart, the heart wall is sutured. If additional revascularizing intervention is necessary, aneurysm resection with CABG are performed simultaneously.

In the preoperative period, patients with a left ventricular aneurysm receive cardiac glycosides, anticoagulants, hypotensive drugs, and oxygen therapy.

As a rule, small left ventricular aneurysms do not require special methods of repair after the procedure. The defect after aneurysmectomy can be closed by a simple linear suture, which is effective and the most suitable option for such situations.

After left ventricular aneurysmectomy and possible plasty, the development of low ejection syndrome, repeated myocardial infarction, arrhythmias (paroxysmal tachycardia, atrial fibrillation), suture failure and bleeding, respiratory failure, renal failure, cerebral thromboembolism is possible.

Is it worth going abroad for treatment during a lockdown?

All of the above conditions pose a serious threat to a person’s life, so the start of treatment should not be delayed. Left ventricular aneurysm surgery should only be performed by an experienced physician because it is a very complex intervention. And the absence of timeliness and quality of the intervention becomes the reason why people go abroad to treat left ventricular aneurysms.

You might think that it isn’t worth jumping straight into it in the middle of a lockdown. But if you need to go abroad for treatment, you can. Yes, you may need to wait a bit longer to get a visa, but it also doesn’t have to be that way.

Booking Health knows all of the ways to organize the left ventricular aneurysm surgery as soon as possible. The company will help you to get a visa if you’re applying for the first time or if your request has been declined. Booking Health will also help you choose a hospital that suits your preferences, prepare all the necessary documentation, book the flight tickets and accommodation, and will do every single treatment-related thing for you.

For Booking Health to help you, please, leave a request on the official website, and a medical advisor will contact you.

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Health & Wellness

COVID-19: WHO expresses hope worst of Omicron wave is over

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Omicron continues to sweep the world, but cases seem to have peaked in some countries, which gives the head of the World Health Organization (WHO) hope that the worst of this latest wave of COVID-19 is over. 

Briefing journalists in Geneva, Tedros Ghebreyesus said that more than 18 million cases were reported last week, and the pandemic itself is far from over, so no country is out of the woods yet.

The number of deaths remains stable, but the agency is concerned about the impact the variant is having on already exhausted health workers and overburdened health systems.

“I remain particularly concerned about many countries that have low vaccination rates, as people are many times more at risk of severe illness and death if they’re unvaccinated”, Tedros said. 

Omicron may be less severe, but for the WHO chief “the narrative that it is mild disease is misleading, hurts the overall response and costs more lives.”

Tedros noted that the virus is circulating “far too intensely with many still vulnerable” and argued that, for many countries, the next few weeks remain critical.

COVAX

Over the weekend, the UN-backed COVAX facility delivered its one-billionth dose of vaccine. 

Tedros said he was proud of the milestone, but believes it’s essential to keep forging ahead with distributing shots fairly, across the world. 

“Vaccines may be less effective at preventing infection and transmission of Omicron than they were for previous variants, but they still are exceptionally good at preventing serious disease and death”, he explained. 

For him, immunization continues to be “key to protecting hospitals from becoming overwhelmed.”

Tracking the virus

The WHO chief also highlighted the importance of tracking new variants, like Omicron, in real time.

Tedros believes that the pandemic is “nowhere near over” and, with the incredible growth of Omicron, new variants are likely to emerge

So far, more than 7 million whole genome sequences from 180 countries have been submitted to GISAID, a global mechanism that provides open access to genomic data and was initially set up to track flu.

Using all that data, new formulations of vaccines are being developed and assessed for how they perform against different strains. 

Despite those efforts, Tedros is concerned that the world will enter “a second and even more destructive phase of vaccine inequity”, if it doesn’t change course. 

New treatments 

Last Friday, WHO recommended two new COVID-19 treatmentsto fight severe illness and death: a rheumatoid arthritis drug called baricitinib and a monoclonal antibody called sotrovimab.

For Tedros, the challenge, once again, is that high prices and limited supply means access is limited.

WHO is currently working with its partners in ACT-Accelerator to negotiate lower prices with manufacturers and ensure supply will be available for low- and middle-income countries.

Meeting

Next week, the WHO Executive Board, which is made up of 34 Member States, will meet to discuss the world’s health challenges.

The pandemic will remain at the forefront, but Member States will also be discussing the devastating impact of the pandemic on other health issues, and how the backsliding can be stopped. 

According to the WHO chief, the agency willbe working to accelerate progress on negotiations around a global pandemic accord.

Cervical Cancer Awareness

On a final note, Tedros noted that January is Cervical Cancer Awareness month.

In 2020, an estimated 604,000 women were diagnosed with cervical cancer worldwide and about 342, 000 women died from the disease.

The main cause of the disease is infection with high-risk types of human papillomavirus (HPV), an extremely common family of viruses that are transmitted through sexual contact.

There are, however, vaccines that protect against high-risk HPV types, which means it should be one of the most preventable and treatable forms of cancer.

On Monday, Serbia announced that this year,it will introduce a vaccination programme against HPV, joining the 116 nationswho already do it. 

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Health & Wellness

UN-backed COVAX mechanism delivers its 1 billionth COVID-19 vaccine dose

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photo © UNICEF/Aimable Twiringiyima

With a 1.1 million jab delivery in Rwanda this weekend, the World Health Organization’s multilateral initiative to provide equal access to vaccines for all reached the one billion milestone.

Along with the Coalition for Epidemic Preparedness Innovations (CEPI), the Vaccine Alliance GAVI, and partners, WHO has led the largest vaccine procurement and supply operation in history with deliveries to 144 countries to date.

According to a press release published on Sunday, as of 13 January 2022, out of 194 countries members of WHO, 36 have vaccinated less than 10% of their population, and 88 less than 40%.

COVAX’s ambition was compromised by hoarding/stockpiling in rich countries, catastrophic outbreaks leading to borders and supply being locked. And a lack of sharing of licenses, technology, and know-how by pharmaceutical companies meant manufacturing capacity went unused”, the agency explained.

On 24 February 2021, Ghana became the first country in the world to receive vaccines through COVAX when 600,000 doses of the Oxford–AstraZeneca vaccine were delivered to Accra. 

The work that remains

COVAX is currently working with governments, manufacturers and partners to ensure that when countries receive vaccines, they can get them to people quickly.

“The work that has gone into this (1 billion) milestone is only a reminder of the work that remains”, the UN’s health agency underscored.

They added that with updated vaccines in the pipeline, citizens should demand that governments and pharmaceutical companies share health tools globally and “bring an end to the death and destruction cycles of this pandemic, limit new variants and drive a global economic recovery”.

COVAX is one of three pillars of the Access to COVID-19 Tools (ACT) Accelerator, which was launched by WHO in April 2020 in response to the pandemic.

The ACT Accelerator is a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. 

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Health & Wellness

WHO recommends two new drugs to treat patients with COVID-19 

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Around two million doses of Sotrovimab are being produced globally in the first half of 2022. © GlaxoSmithKline

The World Health Organization (WHO) on Thursday reccommended two new drugs to treat patients with COVID-19, one for patients with critical disease, and another deemed effective for non-severe cases.

The first drug, baricitinib, is a Janus kinase (JAK) inhibitor- a class of drugs used to treat autoimmune conditions, blood and bone marrow cancers, and rheumatoid arthritis.

According to the WHO Guideline Development Group, it is “strongly recommended” for patients with severe or critical disease in combination with corticosteroids.

The group of international experts based their recommendation on “moderate certainty evidence” that it improves survival and reduces the need for ventilation.

There was no observed increase in adverse effects.

The experts note that it has a similar effectas other arthritis drugs called interleukin-6 (IL-6) inhibitors. Because of that, when both drugs are available, they suggest choosing the best option based on cost, availability, and clinician experience.

It is not recommended to use both drugs at the same time.

The experts also advise against the use of two other JAK inhibitors (ruxolitinib and tofacitinib) for patients with severe or critical cases of COVID-19 infection.

According to them, trials undergone using these drugs failed to show any benefits arising using either drug,and suggested a possible increase in serious side effects with tofacitinib.

Non-severe cases

In the same update, WHO makes a conditional recommendation for the use of a monoclonal antibody known as sotrovimab in patients with non-severe cases.

According to them, the drug should only be administered to patients at the highest risk of hospitalisation. In those at lower risk, it onlyshowed “trivial benefits”. 

A similar recommendation has been madepreviously, for another monoclonal antibody drug, casirivimab-imdevimab, and the experts say there is insufficient data to recommend one over the other.

For both, the effectiveness against new variants, like Omicron, is still uncertain. 

The group will update their guidelines for monoclonal antibodies when more data becomes available.

Recommendations

These recommendations are based on new evidence from seven trials involving over 4,000 patients with non-severe, severe, and critical infections.

Developed by WHO with the methodological support of MAGIC Evidence Ecosystem Foundation, the guidelinesprovide trustworthy guidance and help doctors make better decisions with their patients.

According to the agency, the guidelines are useful in fast moving research areas, because they allow researchers to update evidence summaries as new information becomes available.

The latest guidance also updates recommendations for the use of interleukin-6 receptor blockers and systemic corticosteroids for patients with severe or critical COVID-19; conditional recommendations for the use of casirivimab-imdevimab (another monoclonal antibody treatment) in selected patients; and against the use of convalescent plasma, ivermectin and hydroxychloroquine, regardless of disease severity.

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