[Digital subtraction angiography in the diagnosis of Fallot 's tetralogy]. / Digital'naia subtraktsionnaia angiografiia v diagnostike tetrady Fallo.

The authors analyze the efficacy of digital subtraction angiography (DSA) in the diagnosis of Fallot's tetralogy (FT); this method helps simplify and cut down the scope of investigations but does not deteriorate their informative value. DSA findings in 120 patients with TF are analyzed. The study was confined to right ventriculography in the majority of cases, which permitted clear-cut imaging of the anatomical details of the defect due to computer processing of the image. Morphometrical parameters were used to make assessment of involvement of the pulmonary artery system more objective: the ratio of the width of various portions of the pulmonary artery system to the width of descending aorta and the pulmonary arterial index characterizing the area of section of both pulmonary arteries in relation to body surface. The quality of imaging the stenoses and hypoplasia in the pulmonary artery system was high, meeting the requirements of present-day surgery. Moreover, DSA helps diagnose other anatomical particulars of TF and the concomitant defects and abnormalities, left ventricular hypoplasia and the type of right aortic arch among other things. The advantages of DSA in the diagnosis of TF are a lesser volume of catheterization, reduced number of sessions and of the dose of contrast agent infused at each session, better imaging of the anatomical details of the defect and of concomitant defects and abnormalities. All this permit examinations on an outpatient basis.

[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.