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Concomitant cardiovascular diseases in elderly patients with a hip fracture significantly increase the risk of developing postoperative complications. Developing the treatment algorithm for a combination of two or more diseases in this category of patients is the main task. The advantages of simultaneous surgery are one-stage repair of two or more surgical diseases, the implementation of one anesthetic procedure, the reduction in the total time of the patient’s stay in the hospital and the reduction in rehabilitation time. This paper presents the clinical observation of simultaneous surgical treatment of severe aortic stenosis and femoral neck fracture in an elderly patient.

The objective of this article was to analyze current researches on the peculiarities of performing coronary artery bypass grafting in patients who primarily underwent intraluminal angioplasty and stenting due to acute coronary syndrome. Despite the priority of stenting in patients with acute coronary syndrome (ACS), there is still a significant number of unresolved issues in this category of patients, especially when these patients, previously stenting due to ACS, undergo coronary artery bypass grafting due to a repeated ACS case. The tactics of management and preparation of patients who were admitted for repeated CABG after preliminary stenting are still not clear, and therefore, a significant number of unresolved issues remains when performing CABG against the background of repeated ACS cases with a previously compromised vascular bed and the presence of chronic inflammation in the coronary arteries. Questions about the perioperative and postoperative complications in this category of patients remain open. We analyzed the latest works and researches about that problem using such systems as NLM, Google Scholar and Elibrary. Due to the current situation of mass use of stenting, a number of questions remain open (the time of cancellation of double disaggregation therapy, the need for shunting the previously stented vessel, the possibility of performing a combined method of treatment for ACS). There is a very little information on the need to bypass the previously stented coronary artery at an earlier date than indicated in the European recommendations.

Risk stratification in elderly patients is very important, as none of the applied models for the prediction of mortality in cardiac surgery does not take into account the whole complex of physiological features of the aging organism.The objective was to analyze the effectiveness of the method of qualitative assessment of biological age.Material and methods. Our study included 127 patients (87 male and 40 female) aged 65 to 84 years (mean age – 72.2±4.7 years) who underwent elective cardiac surgery. Perioperative factors were analyzed. The primary endpoint of the study was a 30-day mortality rate.Results. The total 30-day mortality rate was 13.4 % (17 patients). Perioperative predictors of 30-day mortality rate were the calculated values of the CAF scale (p=0.006), the surgery volume (p=0.044), the use of extracorporeal blood circulation (p=0.048).Conclusion. The use of qualitative assessment of biological age allows to more accurate predict the mortality in cardiac elderly patients.

The article provides the results of minimally invasive direct revasculization of myocardium at the period from 2012 to 2014. Given method was used in 49 interventions. There weren’t any lethal cases or myocardial infarctions. A mean hospital stay consisted of 8,6±2,7. Computer thomographic coronary bypass angiography was carried out after operation in terms of 6-48 months. The occlusion of mammary coronary shunt was revealed in 3 patients with minimally invasive revasculization of the myocardium in terms up to 48 months. There were noted a decrease of hospital stay, bleeding during surgery and in early postoperative period, duration of artificial pulmonary ventilation, length of stay in intensive care unit for this group of patients.