[Evaluation of late results of radical correction of tetralogy of Fallot based on treadmill test]. / Otsenka otdalennykh rezul'tatov radikal'noi korrektsii tetrady Fallo po dannym

The treadmill test was conducted, according to an elaborated program for evaluating insufficient pumping function of the left/right heart and the threshold of +lactic acidosis decompensation, in 53 patients before and in 86 patients after radical correction of Fallot's tetralogy. Insufficiency of left-heart pumping functions occurred after the operation significantly less frequently in patients with a monocuspic graft (14 +/- 7%; M +/- m) and more frequently in suture plastics (54 +/- 14%). A similar tendency was also authentic for right-ventricular ejection and decompensation of acidosis load. It was proved that patients with a monocusp are distinguished by higher and most stable results for a period of 5 years after the correction. Lower results were characteristic of transannular plastics and of patients who were operated on through a longitudinal approach; the lowest results occurred in suture plastics through a transverse approach. It was found that ++re-shunting of the ventricular septal defect levels the results of the various types of correction of the anomaly. It is shown that the criteria of insufficiency of the heart pumping function may be used in the diagnosis of latent stenoses and regurgitations of the infundibulum of the heart and the pulmonary artery whose functional significance is revealed only during a load.

[Critical periods in the pubertal development of girls]. / Kriticheskie periody v pubertal'nom razvitii devochek.

The authors analyze the results of physical and sexual development of girls at the pubertal period, as well as their blood levels of hormones participating in the growth regulation and characterizing the +hypophyseal-gonadal relations. A staged pattern of pubertal period is emphasized+ and the critical period singled out: the age of menarche onset and establishment of the ovulation cycle (at the age of 14-15).

[Treadmill test in objective evaluation of late results of radical correction of tetralogy of Fallot]. / Tredmil-test v ob''ektivnoi otsenke otdalennykh rezul'tatov radikal'noi korrektsii tetrady Fallo.

The many-stage treadmill test was carried out according to a worked-out program in 41 patients before and in 55 patients after radical correction of Fallot's tetrad (40 healthy individuals were the controls). The pump function of the heart (oxygen debt dynamics), the anaerobic threshold (complex of gas analytical indices), and the efficacy of blood flow in lesser circulation (O2 consumption plateau) were appraised. The results proved to be best according to all criteria in patients with trans-annuloplasty of the conus arteriosus and pulmonary trunk with the use of a monocusp graft, and poorest in patients who were operated on through a transverse approach. This regularity was also encountered in 31 patients who were studied in follow-up periods of 3 years after the operation.

[Quantitative assessment of hemodynamics function in treadmill test in patients after radical correction of Fallot's tetrad]. / Kolichestvennaia otsenka funktsii gemodinamiki v tredmil-teste u bol'nykh posle radikal'noi korrektsii tetrady Fallo.

Long-term examination findings in 78 patients after radical correction of Fallot's tetralogy and preoperative assessment of the circulatory status in 68 patients using treadmill test are analysed. The quantitative estimates of circulatory defects at different levels at later postoperative terms (from 6 months to 6 years) depended on the type of plastic surgery of the outflow part of the right ventricle and pulmonary trunk: suture plasty, right ventricular outflow plasty with a xeno-pericardial flap, and transannular plasty with the use of a mono-septal xeno-pericardial graft. Preoperatively, 59.0 per cent patients were attributed to functional class IV and 41.0 per cent patients to class III. After the radical tetralogy correction, most patients (55.0 per cent) were related to the functional class I. The advantages of using mono-septal xeno-pericardial grafts for plastic surgery of the right ventricular outflow and pulmonary trunk are demonstrated.