[The treatment of critical valvular stenosis of the pulmonary artery by the balloon valvuloplasty method in patients in the first 3 years of life]. / Lechenie kriticheskogo klapannogo stenoza legochnoi arterii metodom ballonnoi val'vuloplastiki u bol'nykh pervykh 3 let zhizni.

The work generalizes the experience of the Bakulev Institute of Cardiovascular Surgery in balloon valvuloplasty of valvular pulmonary stenosis in 58 children of the first 3 years of life: 8 were 1 to 6 months of age, 10 were 7 to 12 months of age, 18 were 13 to 24 months old, and 22 were 25 to 36 months old. Cyanosis was found in 27 of them. As the result of balloon valvuloplasty, the systolic pressure gradient between the right ventricle and the pulmonary artery reduced from 114.7 +/- 12.6 to 31.4 +/- 7.2 mm Hg in children under 1 year of age, from 143 +/- 12.6 to 40.1 +/- 8.3 mm Hg in children aged from 1 to 3 years. In patients with cyanosis, saturation of arterial blood with oxygen increased to 92%. The late-term results were studied in follow-up periods of 6 to 36 months in 35 patients, by means of catheterization and angiocardiography in 15 of them. Analysis showed balloon valvuloplasty to be effective. Balloon valvuloplasty was repeated in 5 patients with critical stenosis because a hemodynamic effect was not achieved by the first dilatation.

[Effects of the Blalock-Taussig operation on the development of the pulmonary artery in patients with tetralogy of Fallot]. / Vliianie operatsii Bleloka--Taussiga na razvitie legochnoi arterii u bol'nykh s tetradoi Fallo.

The effect of the Blalock-Taussig operation on the growth of the pulmonary arteries (PA) in infants with tetralogy of Fallot (TF) was studied in late-term periods. Thirty-eight patients were examined, angiography and study of hemodynamics were conducted 31 to 144 months after the Blalock-Taussig operation. The obtained data provide evidence that as the result of the operation all segments of the hypoplastic PA grew to such a size that radical correction of the anomaly could be accomplished. In patients with an initially normal size of the PA growth of the vessel was not encountered. Iatrogenic complications and deformities of the PA occurred in 13.2% of cases. These complications developed most frequently (7.9%) in patients in whom the anastomosis was established in the first year of life. The degree of severity of the infundibular stenosis grew in all patients. Severe obstruction of outflow from the right ventricle developed in 10.5% of patients; in 7.9% of children it was completely obstructed. In view of that prolonged delay of the second stage of surgical treatment is inexpedient.

[Angiographic signs and pathophysiology of abnormal origin of the left coronary artery from the pulmonary trunk]. / Angiograficheskaia semiotika i patofiziologiia anomal'nogo otkhozhdeniia levoi koronarnoi arterii ot legochnogo stvola.

The results of intracardiac examination of 37 patients with anomalous origin of the left coronary artery from the pulmonary trunk were studied. On the basis of anatomo-angiographic++ comparisons the authors point out the characteristic features of coronary circulation and affection of the left ventricular myocardium which determine the clinical manifestations of its dysfunction. The functional condition of the left ventricle was appraised depending on the character of development of the intercoronary collaterals.

[Anatomically corrected transposition of the great vessels]. / Anatomicheski korrigirovannaia transpozitsiia magistral'nykh sosudov.

The paper is concerned with the description of a rare congenital heart disease: anatomically corrected malposition of major vessels in a 9-mos 24 day old girl. The diagnosis of this disease was shown on the results of angiocardiography, concomitant congenital heart diseases were described. This abnormality is characterized by common atrioventricular and ventriculovascular joints and inversion position of the major vessels, it is always attended by congenital heart diseases, such as an interventricular septal defect combined with pulmonary stenosis. Surgical intervention is aimed at the elimination of concomitant heart diseases.

[Transluminal balloon valvuloplasty and aortoplasty in the treatment of congenital heart defects]. / Transliuminal'naia ballonnaia val'vuoplastika i aortoplastika v lechenii nekotorykh vrozhdennykh porokov serdtsa.

The authors' experience in endovascular treatment of such congenital heart defects as pulmonary valvular stenosis (PVS), aortic valvular stenosis (AVS), and aortic coarctation (AC) is presented. Transluminal balloon dilatation was performed in 46 patients: in 30 patients with PVS, 11 patients with CA, and 4 patients with AVS, the patients' age ranging from 7 months to 45 years. Transluminal balloon valvuloplasty was performed using 'Schneider-Medintag' catheters (Switzerland). In PVS patients, the systolic pressure in the right ventricle (RV) was reduced after the procedure from 129 +/- 10.4 to 58 +/- 3.5 mm Hg, the systolic pressure gradient (SPG) between the right ventricle and pulmonary artery fell from 111 +/- 10.6 to 35 +/- 3.8 mm Hg, and the pulmonary valve opening was enlarged from 13.4 +/- 1.5 to 69 +/- 3.9 mm2. Late (6-18-month) results were studied in 5 patients. In CA and reversed CA patients, the SPG between the ascending and descending aorta was reduced from 47.0 +/- 1.7 to 16.0 +/- 3.7 mm Hg, the coarctation diameter increased from 4.5 +/- 0.6 to 8.2 +/- 2.3 mm. In congenital AVS patients, the SPG between the left ventricle and aorta was reduced from 106.5 +/- 35.1 to 39.5 +/- 8.1 mm Hg. Thus, the transluminal balloon valvuloplasty is an effective therapeutic intervention and might be an alternative to surgical treatment. Further experience will allow one to specify indications to its performance in congenital heart disease.