[Use of antiseptic dekasan in complex treatment of peritonitis].

Experience in treatment of 91 patients with peritonitis on various genesis using antiseptic Dekasan are presented. A marked clinical efficacy compared with that of other antiseptics in the complex treatment of peritonitis was noted.

[One-stage combined operations on the organs of the abdominal cavity in compression stenosis of the celiac trunk]. / Odnomomentnye sochetannye operatsii na organakh briushnoi polosti pri kompressionnom stenose chrevnogo stvola.

The authors made an analysis of 511 operations for chronic abdominal ischemia caused by stenosis of the celiac trunk performed during 20 years. In addition to decompression of the celiac trunk, one-stage combined operations on the organs of the abdominal cavity were made in 167 out of 511 patients for concomitant diseases. It was shown that adequately fulfilled operations on organs of the abdominal cavity with stenoses of the celiac trunk improved the results of operations for the stenosed vessel.

[Demonstration of obstruction of blood outflow from the left and right ventricles in idiopathic hypertrophic subaortic stenosis]. / Vyiavlenie obstruktsii putei ottoka krovi iz levogo i pravogo zheludochkov pri idiopaticheskom gipertroficheskom subaortal'nom stenoze.

A comparative assessment of the value of routine clinical and intracardiac investigation procedures for the diagnosis of idiopathic hypertrophic subaortic stenosis (IHSS) was carried out in 12 patients with simultaneous obstructions of the left- and right-ventricular blood outflow pathways caused by hypertrophy of the interventricular septum. It is suggested that electrocardiographic and roentgenologic evidence of overloaded right and left compartments of the heart signals are indicative of the need for simultaneous catheterization and angiocardiography of the right and left compartments that can detect right-ventricular obstruction in the IHSS patients. Intravital diagnosis of the obstruction makes possible complete correction of the defect, whereas an isolated removal of the left-ventricular obstruction is not successful in the presence of an obstruction in the right ventricle.

[Late results of the surgical treatment of interventricular septal defects]. / Otdalennye rezul'taty khirurgicheskogo lecheniia defektov mezhzheludochkovoi peregorodki.

The work deals with the following three problems: the criteria for the appraisal of the remote results; the evolution of pulmonary hypertension following correction of the defect; the indications for a repeated operation in reshunting. The examination was conducted on a group of 132 patients in postoperative periods of up to 13 years (5 years on the average) who had undergon surgery at the age of over 3 years. The analysis shows that the findings of clinical, electro-, phonocardiographic and X-ray examination are only of auxilliary importance as the criteria for the evaluation of the remote results. Changes in hemodynamics in remote periods after closure of the defect are the main indices of the efficacy of surgical management of patients with high pulmonary hypertension; it is just these changes that determine the prognosis. Considerable improvement in hemodynamics is revealed in most patients, which attests to the efficacy of surgery. In 29.2% of patients of the older age groups, however, mild or severe affection of the vessels of the pulmonary circulation was discovered. These data are an important argument in favour of early radical correction of the defect. In partial reshunting on the background of considerable improvement in hemodynamics and the general condition of the patient, one may refrain from carrying out an operation again and continue dynamik observation of the patient.

[Evolution of pulmonary hypertension in the late period following correction of congenital heart defects]. / Evoliutsiia legochnoi gipertenzii v otdalennye sroki posle kornektsii vrozhdennykh porokov serdtsa

The presented analysis is based on the data of haemodynamics studies in 62 congenital heart disease patients prior to and following surgery within 1 to 13 years (mean -- 5 years). Patent arterial duct ligation was performed in 34 cases, ventricular septal defect was closed in 28. Twenty of the patients had moderate, 42 -- high pulmonary hypertension (IIIa stage in 37 cases, IIIb stage -- in 5). Late postoperative haemodynamic studies have shown that Stage II patients demonstrated its normalization, the pulmonary artery pressure remaining above the normal level only in few cases in whom it had been 50 mm Hg and higher. In IIIa stage patients no normalization of haemodynamics is usually achieved, and in 9.1% of the cases an evolution of the total pulmonary resistance was noted. However, a distinct improvement of the haemodynamic parameters in the majority of such cases proves the efficacy of their urgical management. The persistence of high pulmonary hypertension or its progressive course in IIIb stage patients, caused by the spreading of the sclerotic process in the pulmonary vessles, indicates the inefficacy of surgery in this group of patients.