ABSTRACT
Results of estimation of variability of cardiac rhythms in patients with coronary heart disease during coronary artery bypass surgery are presented. The aim of the study was to search for innovative methods for the assessment of the patients' conditions as a criterion for their rational choice for cardiosurgical intervention to enable adequate anesthesiological support and postoperative follow-up. We revealed additional characteristics of cardiac rhythm variability facilitating such choice and predictors of the risk of life-threatening heart arrhythmias. It is shown that high-resolution analysis of cardiac rhythms allows such peculiarities of dynamics of patient's conditions to be revealed that can not be exposed by the existing standard methods.
Subject(s)
Arrhythmias, Cardiac/etiology , Coronary Artery Bypass/adverse effects , Coronary Artery Disease/surgery , Electrocardiography , Heart Rate/physiology , Intraoperative Complications , Sinoatrial Node/physiopathology , Arrhythmias, Cardiac/physiopathology , Coronary Artery Disease/physiopathology , Follow-Up Studies , Humans , Monitoring, Intraoperative , Treatment OutcomeABSTRACT
The results of surgical treatment of congenital heart diseases in 595 children under 3 years of age are generalized. There were no fatal outcomes after correction of coarctation of the aorta (9 cases), patent ductus arteriosus (312), pulmonary and aortic stenoses (7). Among 62 patients who underwent removal of an atrial septal defect 3 (4.8%) died. Operations were performed on 140 patients for a ventricular septal defect with high pulmonary hypertension, 31 (22.1%) of them died from various causes. Operations for complicated heart diseases were acts of despair in children whose condition was critical.
Subject(s)
Ductus Arteriosus, Patent/surgery , Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Ventricular/surgery , Transposition of Great Vessels/surgery , Age Factors , Child, Preschool , Extracorporeal Circulation , Humans , Hypothermia, Induced , Infant , Intraoperative Care , Pericardium/transplantationABSTRACT
The influence of 4 kinds of anesthesia (neuroleptanalgesia, peridural anesthesia by trimecaine hydrochloride, peridural morphine analgesia, fluoroxene anesthesia) upon the process of reestablishment of blood circulation in lower extremities and possibilities of using a rheographic method for the intraoperative assessment of the efficiency of the aorto-femoral shunting were studied in 112 patients with the help of rheography of the shin and great toes. The authors recognize that trimecaine hydrochloride anesthesia and peridural sympathetic block allow with the help of rheography to timely detect an inadequacy of the aorto-iliac reconstruction in 9 cases.
