[Superior vena cava blood flow measurements for results prognosing of a bidirectional cava-pulmonary anastomosis in correction of hemodynamics parameters in patients with hypoplastic right ventricle].

The method of prediction the enability of closure atrial septal defect before operation or in pre-bypass period during the one and one-half ventricle repair of CHD with hypoplastic right ventricle was presented. The method is based on comparison of the initial blood flow on superior vena cava (SVC) and right-to-left shunt at atrial level. Defect can be closed if flow on SVC and shunt flow are approximately equal. According to prognosis in 16 of 37 patients defect was closed. After operation there were not signes congestive heart insufficiensy and cyanosis. This approach allowes to avoid reoperations at least in half of patients. If shunt flow exceeds flow on SVC, defect must be left open.

[Surgical treatment of the aortic arch aneurysm. Immediate results]. / Khirurgicheskoe lechenie anevrizmy gugi aorty. Blizhaishie rezul'taty.

There was performed the retrospective analysis of 23 consecutive patients, to whom beside the ascending aorta aneurysm correction the aorta arch prosthesis was done in conditions of deep hypothermia, the blood circulation arrest with retrograde cerebral perfusion via vena cava superior. For an acute layering and aneurysm of aorta with pericardium tamponade or hemothorax occurrence 16 (69.6%) of patients were operated on in emergency. Hospital mortality had constituted 21.7%, including after an urgent operation performance--25% and elective surgery--14.3%.

[Anti-arrhythmia therapy of acute heart rhythm disorders in the early period after heart valve prosthesis]. / Antiaritmicheskaia terapiia ostrykh narushenii serdechnogo ritma v rannie sroki posle protezirovaniia klapanov serdtsa.

The paper reports the results of a comparative study of the efficiency of antiarrhythmic drugs with different mechanisms of action and quickening electric cardiostimulation (ECS) in 640 patients with acute heart rhythm and conductivity disorders that had developed at early dates after the introduction of valvular prostheses. Beta-adrenoblockers and isoptin were shown to be effective in the control of supraventricular tachysystolic rhythm disorders, membrane-stabilizing agents are indicated in ventricular extrasystole, and ECS combined with trimecaine, in bradyarrhythmias. Arterial hypotension associated mostly with obsidan administration, and functional central nervous disturbances observed with membrane-stabilizing agents are reported as the most common side effects. Transformation of arrhythmias into a more severe condition--ventricular tachysystole, fibrillation and asystole--is possible when obsidan or ECS are used.

[Valve prosthesis in the surgical treatment of acquired heart defects]. / Protezirovanie klapanov v khirurgicheskom lechenii priobretennykh porokov serdtsa.

The authors describe their experience with cardiac valve prostheses in 2446 patients with acquired heart diseases and hospital mortality of 21.7%. The surgical methods and the tactics in concomitant diseases are described. The methods of plastic operations on the tricuspid valve are presented. Late results of prostheses of the cardiac valve were studied in 1594 patients. Good late results were recorded in 65.9% of cases, satisfactory in 17.1%, unsatisfactory in 4.3%. The late mortality was 12.7%. Analysis of the late complications is given and the ways for increasing the efficacy of cardiac valve prostheses are suggested.

[Effect of the preoperative status indices on the late results of aortic valve prosthesis]. / Vliianie nekotorykh pokazatelei predoperatsionnogo sostoianiia na otdalennye rezul'taty protezirovaniia aorta'nogo klapana.

The authors studied late results of replacement of the aortic valve by a ball prosthesis in 292 patients up to 11 years. Good results were obtained in 82.2% of the patients, satisfactory in 7.4%, unsatisfactory in 3%; 7.4% of patients died during late periods. The factors that deteriorate the late results of aortic valve prosthesis are the duration of subjective symptomatics over 5 years before the operation, the presence of the right ventricular decompensation, cardiomegaly, high end diastolic pressure in the left ventricle, neglected stage of the disease. These data are confirmed by the analysis of actual curves of survival and stability of the good late results of the operation.

[Rehabilitation problems with heart valve prosthesis patients]. / Voprosy reabilitatsii bol'nykh a protezami klapanov serdtsa.

A vast experience of over 1500 patients with prostheses of the heart valves is being summarized. A method of physical and psychological rehabilitation of these patients is described and data are given proving the efficacy of such measures: increased physical endurance in work by 92%, decrease of psychic disorders by 41.5%. The efficacy of the sanatorium stage of post-operative treatment is shown. Not infrequently the degree of invalidity of patients with cardiac valve prostheses is exaggerated, it is stressed that the use of exercise tests by the rehabilitation commission is essential.

[Risk factors in aortic valve prosthesis]. / Faktory riska protezirovaniia aortal'nogo klapana

The paper is devoted to the determination of the prognostic value of preoperative and intraoperative symptoms observed in aortic valve prosthetic replacement, as well as to the development of a quantitative criterion of the severity of the patient's state for the evaluation of the risk factor of surgery. The peculiarities of the clinical pattern were analysed in 117 patients operated on for aortic valve pathology. The computerization of the assessment of individual symptoms and their combinations (36 symptoms, 114 signs pertaining to the patient's history, objective, instrumental and radio-surgical examinations) was carried out on the "Minsk-22" computer. The leading factors in the assessment of cardiovascular lesions include the systolic and diastolic pressure, the degree of heart size enlargement, the end diastolic pressure in the left ventricle. Among the independent factors, of greatest prognostic value are the degree of calcification of the aortic valve cusps, the duration of the disease, and the period after the onset of subjective symptoms. The duration of the operative procedure and of the perfusion serves as an additional valuable guideline in making the prognosis of aortic valve replacement.