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.

The optimal choice of landing zone of the aorta is the key to good long-term results of endovascular treatment on the descending thoracic aorta. In patients with Type B aortic dissection and retrograde dissection to the aortic arch, arterial debranching of the aortic arch branches allows to form a safe landing zone and reduce the risk of antegrade endoleak formation and retrograde dissection.

• To analyze chest penetrating chest wounds with heart injury by native computed tomography (CT).
• To differentiate groups of patients who need urgent surgery (life-saving procedures) at the mobile military hospitals and who might be safely transported to the specialized cardiac surgery departments without previous urgent surgical procedures. 

Гостре розшарування аорти типу А (ГРА) зустрічається у 3-х випадках на 100000 осіб у рік із рівнем летальності 1–2% в годину за умов відсутності хірургічного втручання. У пацієнтів зі синдромом Марфана (СМ) РА типу А трапляється у 65% випадків. Золотим діагностичним стандартом ГРА вважається мультиспіральна комп’ютерна томографія (МСКТ) з контрастним підсиленням. Відповідно до рекомендацій Американської асоціації 
серця, кожен п’ятий пацієнт з РА типу А потребує наступного етапу хірургічного лікування впродовж 5 років після першої кардіохірургічної операції

Introduction. Patients with acute myocardial infarction should be treated with early revascularization. Patients over 73
years have a higher risk of infarct-related cardiogenic shock, which is a leading cause of lethality. Unfortunately, little
is known about myocardial revascularization care for elderly people in Ukraine. We presented a 92-year-old lady with
an acute chest pain case report, which was not revealed by analgesics.
Important clinical findings. Coronary angiography revealed thrombotic occlusion of the distal segment of the left anterior descending artery (LAD) and floated thrombus in LAD mid-segment; stenosis of the left circumflex artery (LCx) close to the first obtuse marginal artery (OM1).
The main diagnosis. Acute myocardial infarction with ST-segment elevation of the left ventricle anterior wall (anteriorSTEMI). Calcific aortic valve disease, severe aortic valve stenosis, significant mitral and tricuspid valve regurgitation,
pulmonary hypertension. Heart failure with reduced LVEF (<40%), NYHA class III symptoms.
Intervention. The decision was to perform urgent stenting in LAD and balloon angioplasty in LCx. Successful hospital discharge was after 14 days.
Conclusions. Take-away lessons: Elderly patients with acute myocardial infarction can be successfully treated in Ukraine. Age and comorbidities are not a contraindication for early myocardial revascularization.