[Angiographic Results After Coronary Artery Bypass Grafting].

The main place among cardiovascular diseases takes coronary heart disease. The number of coronary artery bypass surgery increases every year. The large number of coronary artery bypass grafting (CABG) performed worldwide. The need for assessment of grafts patency is enormous. OBJECTIVE: We are performed analyze of graft patency results, after CABG surgery in our clinic. MATERIALS AND METHODS: This paper presents the results of a retrospective analysis of angiographic graft patency data depends of TIMI flow, Syntax score, diameter and degree of vascular lesions, as well as the surgery type. RESULTS: According angiographic data of 142 patients, we found that 74 (52.1 %) had no graft dysfunction. In the 68 (47.9 %) patients had various types graft dysfunction which is 3.0 % of the total number of operated patients in our center for coronary heart disease. 31 (46 %) patients were operated under Off pump, 19 (28 %) - On pump and 18 (26 %) - in a parallel bypass technic. According to our data parameters such as Syntax score, the diameter of the vessel and the percentage of lesion, its did not significantly affect the grafts patency in terms of up to 12,7±6,5 months. Preoperative coronary blood flow (assessed by TIMI scale) the significantly affects the grafts patency. CONCLUSIONS: In the graft patency for perioperative period and follow-up, significantly affected preoperative coronary blood flow assessed by TIMI. The results of beating heart (off pump and using a parallel IR) and On pump surgery similar in the immediate postoperative period. But there is tend to increase graft dysfunction in up to 30 months in patients after off pump surgery. We don't found relation between Syntax score, the diameter of the coronary arteries, the percentage of stenosis and graft patency after 12 months follow-up.

[Experience of Treatment of Spontaneous Rupture of Left Ventricular Posterior Wall After Mitral Valve Replacement].

Spontaneous rupture of the left ventricular posterior wall after mitral valve replacement is a severe complication and is associated with high mortality rate. This complication was first described in 1967 by Roberts and Morrow, which describe the results of autopsy of two patients. In leading clinics around the world left ventricular wall ruptures after mitral valve replacement account for up to 20% of causes of hospital mortality. Currently there is no clear-cut strategy of treatment of this complication. In this article we present analysis of both traditional and non-traditional methods of treatment of this complication as well as own small positive and negative experience.

[The adaptive changes of homeostasis under the influence of high-intensity physical exercises].

The present article was designed to report the results of the investigation into various non-specific adaptive reactions of the organism (NARO) based on the determination of the ratio of lymphocyte to neutrophil levels in the blood of the athletes under conditions of high-intensity training. We evaluated the frequency of different types of adaptive responses in the biathlon skiers at different stages of their annual training cycle. The study has demonstrated the relationship between metabolic changes under the influence of training and the type of adaptive responses. It is concluded that the adaptive stress responses are associated with the increased "metabolic cost" paid for the performance of strenuous exercises which can be a cause of slowdown of the adaptive processes and lead to overtraining.

[Intraoperative assessment of blood flow along coronary and internal thoracic arteries before and after myocardial revascularization].

The article deals with intraoperative assessment of the blood flow in the coronary arteries and internal thoracic artery before and after myocardial revascularization. This is accompanied and followed by ultrasonographic characteristics of the coronary blood flow before and after surgical intervention, as well as competence of anastomoses and functional state of revascularization depending on the degree of the atherosclerotic lesion and the diameter of coronary arteries. The average linear and volumetric velocities of the blood flow in the coronary arteries were found to depend upon the degree of the lesion of coronary arteries, the diameter and capacity of the coronary bed. The work was based on studying a total of forty-eight patients presenting with coronary artery disease and subjected to myocardial revascularization using the internal thoracic artery (ITA). Also determined was efficacy of myocardial revascularization in different diameters of the coronary arteries and parameters of the ITA blood flow.

[Outcomes of surgical management of elderly and aged patients with complicated forms of coronary artery disease].

The article is dedicated to comparative analysis of surgical management of elderly and aged patients presenting with complicated forms of coronary artery disease (CAD). Suggested herein is an algorithm of concerning the choice of methods aimed at surgical correction of postinfarction aneurysms of the right ventricle of the heart and postinfarction ruptures of the interventricular septum in these patients, depending on the morphological structure of the right-ventricular postinfarction aneurysms and postinfarction ruptures of the interventricular septum, followed by determining the incidence rate of using "complete" and "incomplete" myocardial revascularization in elderly and aged patients with complicated forms of CAD depending on peculiarities of the coronary blood flow. Also considered herein is efficacy of preventing rethrombosis following correction of right-ventricular postinfarction aneurysms and thrombectomy. The article is based on studying a total of forty-two 60-to-78-year-old patients with CAD. The measures taken made it possible to decrease postoperative lethality and postoperative complications rate in the patients concerned.

[The influence of vibration training in combination with general magnetotherapy on dynamics of performance efficiency in athletes].

The objective of this study was to evaluate effects of a combined treatment including vibrostimulation and magnetotherapy on the working capacity of athletes. Participants of the study were 8 male judo wrestlers. It was shown that implementation of a specialized training program comprising seances of vibration loading and general magnetotherapy 40 and 60 min in duration respectively during 3 consecutive days produced marked beneficial effect on the hormonal status of the athletes. Specifically, the three-day long treatment resulted in a significant increase of blood cortisol and testosterone levels considered to be an objective sign of improved performance parameters in athletes engaged in strength and speed sports. The optimal length of vibration training during 3 days of specialized training is estimated at 20 to 40 minutes supplemented by general magnetotherapy for 60 minutes.

[Stabilometric studies of the effect of dosed vibration on erect posture parameters in athletes].

Comparison of dynamics ofstabilometric parameters in elite free calisthenics gymnasts in the course of vibration and conventional training demonstrated that the dosed vibration training allowed to somewhat sooner achieve the improvement of intermuscular coordination than the traditional training. Moreover, vibration exercises (unlike conventional ones) resulted in a significant augmentation of the explosive strength of the legs' muscles for eight training sessions during which the total length of vibration exercises did not exceed 160 min. These exercises made it possible to raise the jump height due to the optimization of the body movement technique on the one hand and to the more intense development of physical qualities on the other hand.

[Influence of vibration exercise on leukocytes and platelets in athletes].

Changes in blood leukocytes and platelets induced by vibration and routine exercises allowed us to specify minimal sufficient dose of vibroload in a single performance of vibration exercise and optimal dose of vibroexercise in the series of stimulation sessions. Short-term postexercise changes in leukocytes from patients performing vibration exercise occurred within a lymphocytic phase of myogenic shifts of white blood which is a favourable factor. It was found that positive dynamics of leukocytes and platelets in the series of stimulation sessions takes place after the initial two training sessions in low doses of vibration loads (overall 3, 5 and 7 min). This dynamics changes for negative if the number of stimulation sessions is more than three.

[Effects of rated vibration exercises on peripheral circulation in athletes].

It is shown that dosed vibration training by the method of biological activity stimulation rearranges peripheral circulation, the resultant specific vascular reactions can be characterized as improvement of microcirculation. Adequacy of adaptive changes of peripheral circulation depends on its optimal distribution. Reduced flood flow is accompanied with decreased tonicity of arterioles and veins facilitating fast blood outflow into peripheral veins.

[Risk assessment in preparation for production of POLIMAG-01 device].

The procedure used by medical equipment developer for assessing the risks involved in operation and maintenance of medical equipment is described. Methods for risk assessment and management are delineated. An example of the procedure implementation is given.

[Design principles of the POLIMAG-01 basic model].

The design principles and functional capabilities of the basic model of the POLIMAG-01 magnetotherapy apparatus are described. Technical characteristics of the apparatus are specified. Original engineering solutions involved in the apparatus design provide local, distributed, and general magnetotherapy.

[Possibilities of early surgical correction of postinfarction remodeling of the heart].

Postinfarction remodeling of the heart (PIRH) has unfavorable prognostic value because is associated with elevated risk of fatal arrhythmias, emergence and progression of heart failure. Reversibility of PIRH in early period after myocardial infarction causes interest. We followed dynamics of echocardiographical parameters in a patient who had undergone myocardial infarction with subsequent aorto-coronary bypass operation. Values of left ventricular end diastolic and end-systolic volumes were as follows: baseline - 147 and 70, in the process of infarction - 281 and 141, in 1 month after infarction - 298 and 194, in 10 days after surgery - 194 and 88, in 1 year after surgery - 194 and 83 ml, respectively. Thus PIRH is substantially reversible in the early period after myocardial infarction followed by adequate cardiac muscle revascularization. In can be supposed that at the moment of infarction an abrupt progression of stenotic atherosclerosis of the coronary arteries occurs due to complete or subtotal occlusion of vessels, what aggravates myocardial ischemia and predominantly determines course of subsequent PIRH.

[Correlation between the precision of analogue-to-digital converter and discretion frequency at the P wave base of the electrocardiogram signal]. / O sootnoshenii razriadnosti analogo-tsifrovogo preobrazovatelia i chastoty diskretizatsii pri vydelenii nachala subtsa P élektrokardiosignala.

Described is the interplay between the quantifications of the ECG signal by time, on the one hand, and by amplitude, on the other hand, at the P wave base. Ratios are suggested that can be used to choose a precision of the analogue-to-digital converter for preset values of P-wave parameters ensuring the detection of the P wave with an error not exceeding one time-quantification pitch.

[Surgical treatment of acquired defects and ruptures of interventricular septum]. / Khirurgicheskoe lechenie priobretennykh defektov i razryvov mezhzheludochkovoi peregorodki serdtsa.

Surgical repair of posttraumatic ventricular septal defects, aortic-right ventricular fistulas and postinfarction ruptures of interventricular septum was carried out in 15 patients aged 18-75 years. Methods of radical correction included suturing, plastic repair with synthetic and autopericardial patches, and amputation of cardiac apex. Procedures were performed 14 days - 12 months after myocardial infarction and 1-12 months after penetrating knife wounds of the chest and the heart. Duration of follow-up was from 1 month to 9.5 years. There were no cases of defect recanalization and deaths.

[Postinfarction angina in elderly patients: results of surgical and drug treatment]. / Postinfarktnaia stenokardiia u bol'nykh pozhilogo vozrasta: rezul'taty khirurgicheskogo i medikamentoznogo lecheniia.

Clinical and angiographical characteristics and results of surgical treatment and drug therapy were assessed in 49 men with postinfarction angina (mean age 64.1-/+3.5 years) and 112 patients with progressing and stable angina (mean age 63.8-/+3.0 years). Of 49 patients with postinfarction angina 30 were subjected to coronary artery bypass grafting (CABG) while 19 were treated with drugs only. Remote results were known in 17 and 19 patients of surgical and conservative groups, respectively. Average duration of follow-up was 66-/+20 months. Compared with patients with progressing and stable angina those with postinfarction angina had similar amplitude of ST-segment deviation during stress tests, ejection fraction, average number of involved coronary vessels, and profile of concomitant diseases, but higher prevalence of left main stenoses (23.6 and 40.8%, respectively, p=0.05). Among patients with postinfarction angina available for follow-up long-term survival of those treated with CABG was higher compared with patients treated conservatively (p=0.02). Nonfatal myocardial infarction developed in 17.7 and 31.6%, symptomatic improvement was registered in 76.5 and 5.3% of patients in surgical and conservative groups, respectively. In patients with postinfarction angina aged >or=60 years CABG surgery compared with drug therapy was associated with better survival and improved symptomatic status.

[Prospects for prognosis in cardiac surgery: experience from using discriminant linear analysis]. / O vozmozhnostiakh prognozirovaniia v kardiokhirurgii: opyt primeneniia diskriminantnogo lineinogo analiza.

The authors evaluate the possibility of using the discriminant linear analysis in predicting the unfavourable outcomes at aortocoronary bypass. There were investigated 98 patients (the mean age 64.4 +/- 3.0 years) who underwent the surgical revascularization of myocardium in 1992-1997. 56 signs characterizing the demographic, clinical-and-instrumental and operational indices were analyzed. The obtained discriminant equation of operation outcome prediction included 15 signs. The operation for unstable angina, the cholesterol level and the patient's age were the most informative parameters. The total per cent of correct classification was 87.8%. According to the authors' experience the discriminant linear analysis is the informative method of multi-dimensional statistical analysis permitting to reveal the most significant signs that influence on the prognosis of surgical intervention.

[The surgical results in postinfarct aneurysms of the left ventricule and in coronary artery lesions]. / Rezul'taty khirurgicheskogo lecheniia postinfarktnykh anevrizm levogo zheludochka serdtsa i porazhenii koronarnykh arterii.

In 1992-1997 66 patients with ischemic heart disease and postmyocardial infarction aneurysms in the left ventricle in association with 1 to 6 coronary arteries' lesion underwent surgical intervention when aneurysm elimination operations were accompanied by shunting of 1 to 6 arteries, which resulted in a better contractile ability of the ventricle and load tolerance. As compared with the reference literature data the lethality rate reduced by 2.4 times.