[Ischemic heart disease complicated by heart failure: possibilities of surgical treatment].

Aim of the study was to assess remote results of surgical reconstruction of the left ventricle (LV) in patients with ischemic heart disease (IHD) and chronic heart failure (CHF). During 1996-2010 136 patients with IHD complicated by CHD were subjected to surgery. The patients were divided into 2 groups: with LV aneurism (group 1, n=70) and with ischemic cardiomyopathy (group 2, n=66). In all patients we performed coronary bypass surgery and Dor LV reconstruction. Moderate and high degree mitral regurgitation was corrected. Hospital mortality was 5.4% in group 2. There were no inhospital deaths in group 1. In all survivors we noted reduction of LV dimensions and sphericity of LV cavity, increase of LV ejection fraction. Ten year survival was 78 and 56,5% in groups 1 and 2, respectively. In 10 years after surgery 80.2 and 68% of patients, respectively, had no signs of high NYHA class (III-IV) CHF. Thus surgical intervention on all components of intracardiac pathology in patients with IHD with CHF allowed to achieve satisfactory long term results.

[Surgical treatment of infective endocarditis of the right sections of the heart]. / Khirurgicheskoe lechenie infektsionnogo éndokardita pravykh otdelov serdtsa.

The authors present results of surgical treatment of infective endocarditis of the right chambers of the heart in 22 patients subjected to 23 operations. Primary endocarditis was diagnosed in 14 patients, secondary endocarditis in 8 patients. Four patients died. In 12 patients the operations were performed during the active phase of the process. Positive bacterial hemoculture was detected in 11 patients. The operations were performed on the open heart. For correction of valve lesions artificial heart valves were used either with special antimicrobial cuffs ("Silzone") or cuffs impregnated with silver ions ("St. Inda Med.") or treated with a solution of Rifampicin during operation.

[Immediate results of reconstructive surgery in end-stage dilated cardiomyopathy]. / Neposredstvennye rezul'taty rekonstruktivnoi khirurgii terminal'noi stadii dilatatsionnoi kardiomiopatii.

First experiences with multistage surgical reconstruction of the left ventricle, heart valves and coronary arteries in patients with the end stage dilated cardiomyopathy are summarized. During the last three years operations have been made on 21 patients aged from 24 to 63, eight patients having idiopathic cardiomyopathy and 13 ischemic cardiomyopathy. They had markedly disturbed hemodynamics, ejection fraction of the left ventricle less than 30% and its diastolic diameter more than 70 mm. Most of the patients were candidates for heart transplantation. The Batista and Dor operations were made in combination with plastic operations on the mitral and tricuspid valves. In patients with ischemic heart disease myocardial revascularization was also performed. Four patients died after operation from arrhythmia and heart failure, the others' state had improved with less sizes of the heart and 10-12% greater ejection fraction. A conclusion was made that such operations were expedient.

[Development of obstetric and pediatric care in the Samara region]. / Razvitie sluzhby rodovspomozheniia i detstva v Samarskom regione.

The strategic concept of territorial service of maternity and childhood health protection developed in the Samara Region with consideration for obligatory medical insurance can improve the health status of women and children, ameliorate the demographic situation, and decrease the reproductive loss in the Region.