ABSTRACT
There are different ways of the open arterial duct treatment, based on its anatomical form. Endovascular occlusion is considered to be the safest. The morphometric protocol was developed for the adequate choice of the occluder. The first-stand results of the endovascular occlusion of the open arterial duct with the use of two types of guided occluders (Flipper and Amplatzer ductus occluder) are presented in the article.
Subject(s)
Cardiac Catheterization/instrumentation , Ductus Arteriosus, Patent/surgery , Prosthesis Implantation/instrumentation , Adolescent , Adult , Aortography , Child , Child, Preschool , Ductus Arteriosus, Patent/diagnosis , Echocardiography, Doppler, Color , Equipment Design , Follow-Up Studies , Humans , Infant , Middle Aged , Retrospective Studies , Tomography, Spiral Computed , Treatment OutcomeABSTRACT
Short-term results of minimally invasive transcatheter closure of atrial septal defect using Amplatzer septal occluder system (AGA Medical Corporation, USA) at 72 patients are analyzed. Technique of surgical procedure is described in detail. Morphometric protocol used for determination of indications and contraindication for endoscopic closure is also described. The causes of impossibility of endovascular procedures are established. The rate of transoccluder blood bypasses in postoperative period is demonstrated.
Subject(s)
Cardiac Surgical Procedures/methods , Heart Septal Defects, Atrial/surgery , Prosthesis Implantation/instrumentation , Adolescent , Adult , Child , Child, Preschool , Echocardiography , Female , Heart Septal Defects, Atrial/diagnostic imaging , Humans , Male , Middle Aged , Prosthesis Design , ThoracotomyABSTRACT
Overall 812 patients with heart isolated septal defects have been operated. Repeated operations were performed at 23 patients. The follow-up ranged 6 months to 15 years. The causes of repeated surgeries and structure of complications are analyzed in details.
Subject(s)
Heart Septal Defects/surgery , Postoperative Complications/etiology , Adolescent , Adult , Child , Child, Preschool , Echocardiography , Female , Follow-Up Studies , Heart Septal Defects/diagnostic imaging , Humans , Infant , Male , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Prognosis , Reoperation , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
Original surgical method of dilated valvuloplasty is described. In moderate isolated hypoplasia of the fibrous ring of the pulmonary artery this method permits one to perform organ-preserving reconstruction of this zone without transannular plastic operation. Schemes of the surgery, experimental data and clinical experience based on surgical treatment of 31 patients with Fallot's tetrad in combination with hypoplasia of the fibrous ring of the pulmonary artery are presented. Short- and long-term results of the defect correction are reported.
Subject(s)
Heart Septum/surgery , Plastic Surgery Procedures/methods , Pulmonary Artery/surgery , Pulmonary Valve Insufficiency/surgery , Salvage Therapy/methods , Tetralogy of Fallot/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Hypoplastic Left Heart Syndrome/surgery , Male , Pulmonary Artery/pathologyABSTRACT
Anomalous origin of left coronary artery from pulmonary artery is a rare congenital pathology causing death of most patients because of various arrhythmia and heart failure. The authors present 4 cases of this anomaly with description of clinical course, diagnosis and surgical procedures. The first patient was operated upon in 12 years after mitral valve replacement. Ligation of anterior interventricular and circumflex arteries at their origin in this patient was combined with anastomosis between mammary and anterior interventricular coronary arteries. Reimplantation of the left coronary artery into the aortic root was used in other 3 patients with good immediate postoperative effect. Restoration of left ventricular pump function occurred in all 3 patients.
Subject(s)
Coronary Vessel Anomalies , Pulmonary Artery/abnormalities , Vascular Surgical Procedures/methods , Child , Coronary Angiography/methods , Coronary Vessel Anomalies/diagnosis , Coronary Vessel Anomalies/surgery , Diagnosis, Differential , Echocardiography , Electrocardiography , Female , Follow-Up Studies , Humans , Male , Retrospective StudiesABSTRACT
Forty-six patients with double disposition of the major vessels from the right ventricle in combination with stenosis of the pulmonary artery, in sub-aortal and bi-committed defects of the interventricular septum have undergone biventricular intraventricular correction. The most specific and accurate anatomic characteristics were: 1) position of the major vessels (particularly side-to-side); 2) location of two and a part of the third aortal sinuses above the right ventricle; 3) bilateral cone; 4) absence of aorto-mitral contact; 5) location of valves of aorta and pulmonary artery on the same level. One (2,2%) patient died during surgery due to progressed cardiac insufficiency. One (2,5%) patient died 2 years after radical correction of the defect due to progressive dysfunction of the right ventricle.
Subject(s)
Double Outlet Right Ventricle/complications , Double Outlet Right Ventricle/surgery , Heart Septal Defects/surgery , Pulmonary Subvalvular Stenosis/complications , Tetralogy of Fallot/surgery , Adolescent , Adult , Cardiac Surgical Procedures/methods , Child , Child, Preschool , Double Outlet Right Ventricle/diagnostic imaging , Female , Heart Septal Defects/complications , Humans , Male , Pulmonary Subvalvular Stenosis/surgery , Radiography , Tetralogy of Fallot/diagnostic imaging , Treatment OutcomeABSTRACT
From 1987 to 1998, examination and treatment were conducted of 12 patients with infectious endocarditis of the tricuspid valve (TIE). 11 of them were operated. TIE was clinically characterized by lesser circulation thromboembolism and marked right ventricular failure. TIE was successfully diagnosed by echo-CG (diagnostic sensitivity 83.3%). Serious disturbances of cellular immunity demanded immunocorrection. Indications for surgical treatment are listed.
Subject(s)
Endocarditis, Bacterial , Staphylococcal Infections , Tricuspid Valve/microbiology , Adolescent , Adult , Echocardiography , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/microbiology , Female , Humans , Male , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiologyABSTRACT
AIM: To study changes in pulmonary hypertension in patients with isolated mitral valvular defects of rheumatic etiology after surgical correction and in the early postoperative period. MATERIALS AND METHODS: Central hemodynamics in heart chamber probing before operation and intraoperatively were measured in 98 patients with rheumatic mitral defects (41 males, 57 females, mean age 39.5 +/- 8.74). Manometry before and after the defect correction, intraoperative catheterization (cath. Swan-Ganz) for hemodynamics 24-h follow-up were made. RESULTS: After valvular defect correction 90(91%) patients had residual pulmonary hypertension, stage II-III in 41%. CONCLUSION: Patients operated for rheumatic heart disease complicated by pulmonary hypertension often suffer from residual pulmonary hypertension. This requires pharmacological correction.
Subject(s)
Hypertension, Pulmonary/physiopathology , Mitral Valve , Rheumatic Heart Disease/surgery , Adult , Blood Flow Velocity , Blood Pressure , Cardiac Catheterization , Catheterization , Female , Heart Valve Diseases/complications , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation , Humans , Hypertension, Pulmonary/etiology , Male , Monitoring, Intraoperative , Pulmonary Circulation , Pulmonary Wedge Pressure , Rheumatic Heart Disease/complications , Treatment OutcomeABSTRACT
98 patients with isolated rheumatic mitral valve defects of the heart entered the study. Their central hemodynamics was studied intraoperatively before surgical correction of the defect. The results were compared to those provided by conventional noninvasive methods: chest x-ray, ECG, echo-CG, external respiration function test. Correlation analysis using computer intellect PolyAnalyst v.1.01R helped to design a program and practical nomogram which can quantitatively determine the degree of pulmonary hypertension on the basis of digital values of Rv1 wave amplitude (ECG) and right ventricular cavity size (echoCG).
Subject(s)
Diagnosis, Computer-Assisted/methods , Heart Valve Diseases/diagnosis , Hemodynamics/physiology , Hypertension, Pulmonary/diagnosis , Mitral Valve , Adult , Echocardiography , Electrocardiography , Evaluation Studies as Topic , Female , Heart Valve Diseases/complications , Heart Valve Diseases/surgery , Heart Ventricles/diagnostic imaging , Heart Ventricles/physiopathology , Humans , Hypertension, Pulmonary/etiology , Hypertension, Pulmonary/physiopathology , Male , Radiography, Thoracic , Reproducibility of Results , Rheumatic Heart Disease/complicationsABSTRACT
A pilot trial of efficiency of enalapril maleate in the treatment of residual pulmonary hypertension was made in 22 patients operated for rheumatic mitral valve defects. Degree I, II and III of pulmonary hypertension was registered in 5, 13 and 4 patients, respectively. Thus, the patients had NYHA functional classes III and IV (22.7 and 77.3%, respectively. Enalapril given for 6 months in a mean daily dose 12.3 +/- 1.57 mg/m2 (5-30 mg a day) normalized pressure in the pulmonary artery in 18.2% of patients. 50% of patients showed hypertension degree I, only one female retained hypertension degree III. To the end of the treatment the functional classes were the following: II--in 68.2%, III--in 27.3% and IV--in 4.5%.
