[Experience of extracorporeal membrane oxygenation in critical care of respiratory failure in newborn with congenital diaphragmatic hernia in perinatal center].

The article deals with an experience of veno-arterial extracorporeal membrane oxygenation use in preterm infants with congenital diaphragmatic hernia during postoperative period in the perinatal center.

[Use of venovenous extracorporeal membrane oxygenation in 14 months old child with acute respiratory distress syndrome and pneumonia].

UNLABELLED: Extracorporeal life support (ECLS) is used in pediatric patients with ARDS in recent 20 years with survival rate from 50 to 67% Venovenous ECLS was used in 1 year 2 months old patient with ARDS and pneumonia developed in postoperative period after gastral esophagoplasty. Purposes of ECLS use were stabilization child's condition and normalization of gas composition of blood with relative lungs repose. Indications for ECLS were increasing respiratory failure, hypoxemia, low respiratory index (PaO2/FiO2 ratio 47.3), alveolar-arterial gradient of oxygen (A-aDO) 630 mmHg and absence of positive effect from high frequency oscillation (HFO). MATERIALS AND METHODS: ECLS was used in 1 year 2 months old patient with ARDS and bilateral pneumonia developed in postoperative period after gastral esophagoplasty. Deltasteam system (Medos Medizintechnik AG, Germany) with centrifugal pump and servoregulation of blood flow pressure was used for ECLS. Double-lumen cannula with size 12 French was used ECLS was instituted via right internal jugular vein. RESULTS: The patient did not have expressed heart failure. Thus preference was given to venovenous ECLS and not to venoarterial ECLS. Duration of ECLS use was 72 hours. Auscultation parameters and gas exchange improved haemodynamics stabilized parameters of biochemical and haematological analysis normalized and the dynamics x-ray examination was positive after the ECLS use. Patient was decannulated and extubated. CONCLUSIONS: Venovenous ECLS was an only way of life support in child with heavy ARDS and pneumonia developed in postoperative period More observations are needed for more thorough analysis and recommendations.

[Stenting in obstructive pathology of pulmonary artery in patients with various forms of congenital heart failure].

A total of 124 stents were implanted to 91 patients with various forms of congenital heart failure for the resolution of obstruction of 111 segments in pulmonary arteries. All these patients were treated in A. N. Bakulev Research Centre of Cardiovascular Surgery in the period from 1994 to 2007. Analysis of observations in early and late postoperative periods indicates that the efficiency of stenting of obstructed pulmonary arteries was 96.4% and the restenosis rate in the follow-up period 3.9%. It is concluded that stenting of pulmonary arteries is an effective and safe method for the management of obstruction problems. In the majority of patients it allows to avoid surgical intervention on pulmonary arteries.

[The use of assisted circulation in cardiosurgical clinic].

The first experience with the use of different artificial circulation systems for the treatment of critical cardiac insufficiency in A. N. Bakulev Research Centre of Cardiovascular Surgery is described. The authors analyse their efficiency, indications for use, possible causes of complications and fatal outcome.

[The arsenal of extracorporeal circulation systems in pediatric cardiosurgery].

The paper presents the arsenal of extracorporeal circulation systems used in the surgical treatment congenital cardiac diseases. It provides some experience in using the extracorporeal circulation systems, indications for and contraindications for their use, and a working classification of extracorporeal circulatory techniques. Their methodological features, criteria for the adequate use of extracorcopreal techniques, and the results of their application are described.

[The postoperative control of the technical links in the biotechnical system of assisted circulation]. / Posleoperatsionnyi kontrol' tekhnicheskikh zven'ev biotekhnicheskoi sistemy vspomogatel'nogo krovoobrashcheniia.

Presently, it is impossible to develop a completely implantable mechanical self-contained system of extracorporeal circulation that can maintain a patient's heart performance for a long time. In this connection, replacement of a mechanical assister by a biological one is promising as this may clear up a lot of troubles of the mechanical systems. The prominent example of successful realization of the completely implantable self-contained system of extracorporeal circulation is a biotechnological system (BTS) which is formed by dynamic cardiomyoplasty and includes the heart, a cardiac electrode, an implantable blood muscular pump pacemaker (BMPP). A muscular electrode, and muscle autograft that acts as an assister. The authors propose the formalized algorithms of noninvasive postoperative control of the technical links of BTS-BMPP and electrodes. The diagnostic algorithms of BTS containing one- and two-channel BMPP are different and based on electrocardiographic, X-ray, and other noninvasive findings.

[Intraoperative finding of complicated congenital heart defects in dogs]. / Intraoperatsionnaia slozhnogo vrozhdennogo poroka serdtsa u sobaki.

Vitium cordis found in a dog comprised a defect of the interatrial septum, pulmonary artery trunk aneurysm and right pulmonary artery atresia. The heart chambers were filled with polymer protacryl mass for obtaining the cast. No such anomalies have been described in the literature so far. The probability of observing such type of vitium cordis in the human clinics is not excluded.

[Hydrodynamic criteria in the choice of surgical tactics in implanting pulmonary artery trunk prosthesis]. / Gidrodinamicheskie kriterii vybora khirurgicheskoi taktiki pri implantatsii proteza stvola legochnoi arterii.

The paper is concerned with the present-day problem of modern medicine, namely with surgical correction of the diseases of the initial part of the pulmonary circulation. The authors suggest hemohydrodynamic simulation of the right heart complicated by extracardial conduit. The simulation was performed at the high theoretical, practical and methodological level to obtain highly significant information which is likely to have paramount importance for clinical practice.

[Evaluation of the status of cardiac perfusion after implantation of extra-cardiac conduits]. / Otsenka sostoianiia perfuzii serdtsa posle implantatsii extra- kardial'nykh konduitov.

The work discusses the findings of experimental study of perfusion of the myocardium after creation of a peculiar "new" outflow tract from the left ventricle of the heart. As a result, perfusion of a heart with an unnatural outflow tract from the left ventricle was found to be satisfactory. The authenticity of the results was determined by means of two, complementing each other, radioisotope methods--standard study with the use of 201Tl and a new method for producing a positron-emission image. It is concluded that the supply of blood to the myocardium after implantation of an ++apico-aortic conduit is sufficiently effective.

[Adaptive transformation of the architectonics of the left ventricle at long periods following implantation of an apico-aortic conduit (based on data from an experimental study)]. / Adaptatsionnoe preobrazovanie arkhitektoniki levogo zheludochka serdtsa v otdalennye sroki posle implantatsii apiko-aortal'nogo konduita (po materialam éksperimental'nogo issledovaniia).

An original morphological study has been conducted to identify the mechanisms underlying the morphofunctional transformations of the left-ventricular structures taking place at late terms after implantation of the apico-aortal conduit. Analysis of the moulds of the left-ventricular cavity has convincingly demonstrated the peculiar changes in its structures bringing about alterations in the blood ejection mechanism on creation of a new outflow tract from the left ventricle of the heart. The conclusions derived from this work are essential not only for implantation of the apico-aortal conduit but for understanding the mechanisms of blood ejection in some congenital heart diseases.

[Morphogenesis of apico-aortic conduit implantation (data of an experimental study]. / Morfogenez vzhivleniia apiko-aortal'nogo konduita (po materialam éksperimental'nogo issledovaniia).

The article discusses the results of complex morphological research concerned with study of the histological structure of an extracardiac conduit in late-term periods after its implantation into the left ventricular-aortic position. The authors conducted a qualitative analysis of the morphogenesis of implantation of a conduit--an original new outlet tract from the left ventricle of the heart. The rich experimental material confirms the conclusion that the new outlet tract from the left ventricle of the heart is marked by complete functional competence adequate for conditions of systemic circulation.

[Dynamic atriomyoplasty as a method extending F. Fontan's principle in the surgical treatment of complex congenital heart defects (an experimental study)]. / Dinamicheskaia atriomioplastika kak metod, rasshiriaiushchii vozmozhnosti printsipa F. Fontan pri khirurgicheskom lechenii slozhnykh vrozhdennykh porokov serdtsa (éksperimental'noe issledovanie).

The article discusses the data of an original complex experimental research dealing with the study of the possibilities of the method of dynamic cardiomyoplasty in surgical management of complex congenital heart diseases with critical obstructive lesions of the venous atrioventricular valve. An original method for the formation of a peculiar new pumping chamber into the system of pulmonary circulation is described. The hemodynamic efficacy of the operation in the immediate periods after its performance is thoroughly evaluated. Substantiated recommendations are given for the possible use of this method in the clinic in surgical treatment of this difficult contingent of patients.

[Assessment of the state of implanted extracardiac conduits by NMR-tomography]. / Otsenka sostoianiia implantirovannykh ékstrakardial'nykh konduitov s pomoshch'iu IaMR-tomografii.

The object of the work was to reveal the unique possibilities of a highly effective noninvasive method NMR-tomography in evaluating the functional condition of extracardiac conduits in experiments. Conduit models with a stationary flow of blood and 10 dogs with implanted left ventricular-aortic conduit were studied. The studies were conducted on a Soviet MT-1000 NMR tomograph. In all studies with diverse cross sections a distinct location of the heart and the large blood vessels and a "new" left ventricular outlet tract was achieved. Minute features of the inner architectonics of the pumping chamber and the lining of the conduit were detected which could not be found by the routine methods. The study allowed certain conclusions to be made concerning the promising application of NMR tomography in the cardiosurgical clinic. With the use of the method some recommendations may be given for optimization of the designs of extracardiac conduits.