ABSTRACT
AIM: To analyse clinical manifestations of congenital pulmonary artery stenosis (CPAS) and right ventricular outlet stenosis (RVOS), development of its diagnosis depending on anatomic variants of heart disease. MATERIAL AND METHODS: The data on 539 patients examined with conventional clinical and highly informative novel techniques were studied. RESULTS: The analysis of the CPAS and RVOS clinical picture depending on the anatomic variant of the heart disease has shown that clinical symptomatology was of the same type. The data of the tests have some specific features allowing identification of some forms of the heart disease. CONCLUSION: Diagnostic and prognostic significance of the findings was determined which gave rise to an optimal examination scheme with focus on wider use of highly informative techniques.
Subject(s)
Pulmonary Valve Stenosis/diagnosis , Ventricular Outflow Obstruction/diagnosis , Adolescent , Adult , Angiocardiography/methods , Child , Child, Preschool , Echocardiography/methods , Female , Humans , Male , Middle Aged , Pulmonary Artery , Pulmonary Valve Stenosis/congenital , Pulmonary Valve Stenosis/physiopathology , Ventricular Outflow Obstruction/congenital , Ventricular Outflow Obstruction/physiopathologyABSTRACT
Postoperative purulent mediastinitis was observed by the authors in 43 out of 1110 patients. Specific features of the clinical picture and course of this complication are described. The "closed" method of treatment was used in 20 patients. Five of them died from intoxication and arrosive bleeding. The "open" method of treatment of mediastinitis was used in 23 patients with no lethal outcomes.
Subject(s)
Heart Defects, Congenital/surgery , Mediastinitis/pathology , Mediastinitis/therapy , Thoracic Surgical Procedures/methods , Adolescent , Humans , Postoperative Complications , Thoracic Surgical Procedures/adverse effectsABSTRACT
AIM: To study alterations in intracardiac hemodynamics in patients with isolated stenosis of the pulmonary artery (ISPA) and right ventricular outflow tract (RVOT). MATERIAL AND METHODS: The disease course was studied by means of repeated probing of the heart chambers, angiocardiography and echocardiography in 32 patients with ISPA and RVOT. Follow-up was performed for 14 years (mean 44.3 +/- 7.47 months). RESULTS: ISPA and RVOT run differently in adults and children. In initial gradient of systolic pressure (GSP) between the right ventricle (RV) and pulmonary artery (PA) under 25 mmHg, its rise with time in the adults is insignificant while in patients with marked stenosis especially in children GSP elevates greatly. Natural course of ISPA and RVOT depends also on the type of obstruction and the degree of hemodynamic disorders. In isolated valvular PA stenosis if systolic overload of RV is absent, the disease course is favourable and expectation policy is possible. In valvular-infundibular stenosis of RVOT compensating ability of the RV depletes quicker and therefore urgent operation is required. CONCLUSION: Congenital ISPA and RVOT are progressive diseases natural course of which depends on the type of obstruction, severity of hemodynamic disorders and age of the patients.
Subject(s)
Heart Defects, Congenital/physiopathology , Hemodynamics , Pulmonary Valve Stenosis/physiopathology , Ventricular Outflow Obstruction/physiopathology , Adolescent , Child , Heart Defects, Congenital/complications , Humans , Pulmonary Valve Stenosis/complications , Ventricular Outflow Obstruction/complicationsABSTRACT
The results of radical correction of interatrial septum defects and heart diseases associated with it were analyzed after treatment of 502 patients at the age from 5 to 48 years. In most cases (58.4%) the patients were adults. The isolated defect of the interatrial septum was diagnosed in 377 patients. Correction of the defect was performed in 82 patients (16.3%) under mild hypothermia and 420 patients (83.6%) were operated upon under conditions of artificial circulation. General lethality was 7.7%.
Subject(s)
Heart Defects, Congenital/surgery , Heart Septal Defects, Atrial/surgery , Heart Valve Diseases/surgery , Adolescent , Adult , Child , Child, Preschool , Extracorporeal Circulation , Female , Heart Defects, Congenital/complications , Heart Septal Defects, Atrial/complications , Heart Valve Diseases/complications , Humans , Hyperthermia, Induced , Male , Middle Aged , Pulmonary Artery/abnormalities , Pulmonary Valve/surgery , Pulmonary Veins/abnormalities , Trilogy of Fallot/complications , Trilogy of Fallot/surgeryABSTRACT
Echocardiography was made in 69 patients with Fallot's tetrad before and 2 weeks-15 years after forming subclavian-pulmonary anastomosis (SPA). By the anastomosis function the patients were divided into 2 groups. 47 patients with satisfactory function of the anastomosis 3.2+ -1.06 years after the operation comprised group 1. 22 patients of group 2 had marked cyanotic syndrome due to thrombosis of the anastomosis 9.45 + -2.45 years after surgery. Echocardiography in Fallot's tetrad patients before and after SPA specified anatomic components of the defect, size of the left heart and results of the operation.
