ABSTRACT
Under analysis were the results of 386 operations on the "open" heart made for mitral diseases complicated by pulmonary hypertension of different degrees. Prosthetics of the mitral valve was performed in 251 patients, in 135 patients the so-called "organ-saving" correction of the defect was fulfilled. The decision on the method of the defect correction depends on the anatomical particularities, morphological alterations of the valvular apparatus. The main place among the causes of postoperative lethality (9-11%) is occupied by cardiac insufficiency and renohepatic failure which are noted mainly in patients of the IVth functional class.
Subject(s)
Heart Valve Prosthesis Implantation , Hypertension, Pulmonary/complications , Mitral Valve Insufficiency/surgery , Rheumatic Heart Disease/complications , Humans , Mitral Valve Insufficiency/etiology , Postoperative ComplicationsABSTRACT
Under analysis were causes of reoperations in bradyarrhythmic forms of disturbances of conductivity of the heart. 565 operations connected with electrocardiostimulation were performed on 276 patients. Reoperations in patients with the myocardial stimulation were made on 63 patients, with the endocardial stimulation--in 226 patients. Causes of reoperations were as follows: depletion of the source of ECS--31.5%; dislocation of the electrode--8.2%; damage of the electrode--15%, suppuration of the bed, decubitus of the stimulator--28.8%; competing rate--7.4%; break of the contact in the connecting system of the electrode and cardiostimulator--9.4%.
Subject(s)
Bradycardia/therapy , Cardiac Pacing, Artificial/adverse effects , Heart Block/therapy , Pacemaker, Artificial , Bradycardia/etiology , Electrodes, Implanted , Equipment Failure , Humans , ReoperationABSTRACT
The method of spiroveloergometry was used in 97 patients after operation of mitral commissurotomy for studying reserves of pulmonary ventilation and its relation to the level of physical working capacity. The results obtained have shown that in patients of worse functional classes the ventilation potency of the lungs deteriorated which resulted in the restricted physical working capacity. It should be necessarily taken into consideration when making programs for the rehabilitation of cardiosurgical patients.
Subject(s)
Mitral Valve Stenosis/physiopathology , Ventilation-Perfusion Ratio , Adult , Exercise Test , Female , Humans , Male , Maximal Voluntary Ventilation , Mitral Valve/surgery , Mitral Valve Stenosis/surgery , Physical Endurance , Postoperative Period , Spirometry , Vital CapacityABSTRACT
Investigations performed in 172 patients have shown that the state of the myocardium (such parameters as the heart volume, degree of lung hypertension, end-diastolic pressure in the right and left ventricles) is of great importance in pathogenesis of the development of acute heart failure in the early postoperative period in patients with mitral stenosis of the IIIrd and IVth stage of the blood circulation insufficiency.
Subject(s)
Cardiac Output, Low/etiology , Hemodynamics , Mitral Valve Stenosis/surgery , Acute Disease , Cardiomegaly/complications , Cardiomegaly/physiopathology , Heart Rate , Humans , Mitral Valve Stenosis/complications , Mitral Valve Stenosis/physiopathology , Postoperative Complications , Postoperative Period , Prognosis , Pulmonary CirculationSubject(s)
Mitral Valve Stenosis/surgery , Female , Follow-Up Studies , Humans , Male , Mitral Valve Stenosis/bloodABSTRACT
The utilization by the myocardium of 8 substrates of the carboxydrate-lipid metabolism was assessed in 44 patients with the 3d and 4th stages of mitral stenosis before and after mitral commissurotomy by the method of the arterio-venous difference. The character of the myocardium supply with substrates with different energetic value was established to depend and to be a sufficiently objective criterium of prognosis of cardiac insufficiency in the early postoperative period.