[Specific features of cardiorespiratory system in patients with intrathoracic sarcoidosis]. / Osobennosti sostoianiia kardiorespiratornoi sistemy u bol'nykh vnutrigrudnym sarkoidozom.

A hundred thirty eight patients with pulmonary sarcoidosis were examined for the status of the respiratory and cardiovascular systems. There is a trend for external respiratory parameters to decrease as the X-ray stage increases (by 30-50% in Stage IV). The revealed cardiovascular changes in patients with different X-ray stages did not differ significantly and there was no clear correlation with the activity of a process and external respiratory parameters. The only hemodynamic indicator clearly associated with the status of the lung was pulmonary hypertension. The involvement of the heart was ascertained not to depend on the stage and activity of sarcoidosis and on the degree of respiratory disorders clearly, which requires cardiovascular monitoring in all patients with sarcoidosis.

[Long-term hemodynamic characterization of distal anastomoses after aortofemoral reconstruction]. / Gemodinamicheskaia kharakteristika distal'nykh anastomozov v otdalennye sroki posle aortobedrennoi rekontstruktsii.

Duplex scanning was used to characterize the qualitative and quantitative parameters of blood flow in portofemoral bypasses and distal anastomoses in the long-term (3- 144 months) period after operation. In 50% of cases with an end-to-side anastomosis, the examination reverled arterial segment occlusions caudal to the anastomosis. 12.5% of patients showed the maintenance of antegrade blood flow in the native arteries (parallel with the bypass). Retrograde blood flow through the anastomosis was recorded only in 32.5% of cases. As a rule, it was restricted by 1-2 branches of the external iliac artery, reaching the internal iliac artery only in 5% of cases. After one year the cumulative retrograde patency of the end-to-side anastomoses constitute 59.1+/-7.2% and after 5 years it is equal to 18.6+/-9.9%. If the superficial femoral artery was patent, the volume blood flow in the bypass was higher. The rise of the volume blood flow was also induced by the presence of the retrograde patency of the anastomosis which was apparently linked with the origination of an additional runoff pool. This advantage is especially completely realized when the condition of the distal perceptive bed is poor.

Duplex scanning potential at reconstruction of main veins.

The purpose of the present study was to determine the duplex scanning (BS) potential for the evaluation of the results of reconstructive operations for postthrombotic disease. We examined 89 patients who underwent different reconstructions on the deep veins of the lower extremities. The operations included crossover vein graft in unilateral occlusions of the iliac veins (36 patients), bypass grafting in occlusion of the femoral and popliteal veins (12), transposition (23) and autotransplantation (18) of the venous segments containing good valves in recapitalization of the deep great veins. Ultrasound diagnosis of the patency of the veno-venous grafts and function of the transposed or transplanted valves had an accuracy of 100%. DS has been demonstrated to compare very favourably with contrast phlebography. We present the functional characteristics of the blood flow in the veno-venous bypasses when the patient is in the horizontal and vertical positions at rest and under conditions of hydrodynamic provocation of the retrograde blood flow at Valsalva's test, compression tests and of the antegrade blood flow at physical exercise. The tests which upgrade the effectiveness of ultrasonography have been worked out. The morphological variants of lesion of the transplanted venous valve cusps have been established. It is demonstrated that the main cause of valvular incompetence of autotransplants lies in supravalvular (sinusoidal) thrombosis which develops in the early postoperative time, thereby giving rise to the block of the cusps of a transplanted valve. The data on the hemodynamics of venous autotransplants, obtained in the course of the study enable one to select an optimal variant of reconstructive operation, to delineate the postoperative treatment policy and to predict the results of surgical intervention.