[Analysis of results of surgical treatment of patients with infectious endocarditis]. / Analiz rezul'tatov khirurgicheskogo lechenia bol'nykh s infectsionnym éndokarditom.

The results of surgical treatment of 180 patients were studied according to the character of infectious endocarditis (primary--PIE and secondary--SIE), the functional class (FC) in the preoperative period, and the patients' immune status. The survival of patients with PIE (with hospital mortality taken into account) was somewhat higher than that of patients with SIE. Survival in the late-term periods was significantly higher in patients with PIE. There were no fatal outcomes among patients with PIE of FC III, mortality among patients with SIE was 7.7%; mortality in FC IV was, respectively, 10 and 21.6%; the mortality rate among patients with PIE and SIE of FC V was 43.5 and 57.5%, respectively. The late-term results were good in 85.5 and satisfactory in 14.5% of patients. Twenty-one (16%) patients died. Cardiac failure and recurrent sepsis were the main causes of fatal outcomes. The preoperative immunological parameters (the concentration of ceruloplasmin, blood serum IgG and IgM, the activity of lymphocyte mitochondrial enzymes and the neutrophil test) reflect the activity of infectious endocarditis and have an effect on the development of postoperative complications and on the mortality.

[Evaluation of late results of aortocoronary bypass in patients with ischemic heart disease in relation to the bypass function]. / Otsenka otdalennykh rezul'tatov aortokoronarnogo shuntirovaniia u bol'nykh ishemicheskoi bolezn'iu serdtsa v zavisimosti ot funktsional'nogo sostoianiia shuntov.

The authors analyse 82 patients with aggravation of their clinical condition in the late-term periods after aortocoronary shunting. All were subjected to coronaroshuntography 3.6 +/- +/- 0.5 years on the average, after the operation. The main noninvasive criteria of impaired functioning of the shunts were: increase of the degree of angina pectoris (functional class III-IV according to the Canadian classification), diminished tolerance to physical exertion, appearance of "active" myocardial ischemia. Disturbed functioning of the shunts was mainly manifested within the first year, while progression of atherosclerotic changes in the unshunted arteries--in later periods. The main causes of incompetence of the shunts were: small diameter of the shunted arteries, low rate of blood flow in the shunts, and feverish condition of patients lasting for a long time after the operation.

[Dynamics of clinical and functional parameters in patients with ischemic heart disease after aortocoronary bypass surgery]. / Dinamika klinicheskikh i funktsional'nykh pokazatelei u bol'nykh ishemicheskoi bolezn'iu serdtsa, podvergshikhsia aortokoronarnomu shuntirovaniiu.

Complete myocardial revascularization was examined for effects on long-term results of aortocoronary bypass surgery in 219 patients. Myocardial revascularization was proposed to be divided into: (1) truely complete; (2) tentatively complete; and (3) partial. Clinical and functional parameters deteriorated in tentatively complete and partial myocardial revascularization as compared with truely complete revascularization. A positive dynamics in abnormal Q wave signs was found in 9% of the patients after the surgery in the presence of the wave in ECG leads corresponding to the anterior left ventricular wall, in the absence of signs of myocardial asynergy prior to the surgery, and on complete recovery of blood flow in the shunts supplying the diseased myocardial areas.

[Late results of aortocoronary shunting in ischemic heart disease patients in relation to the severity of the coronary lesion and degree of myocardial revascularization]. / Otdalennye rezul'taty aortokoronarnogo shuntirovaniia u bol'nykh ishemicheskoi bolezn'iu serdtsa v zavisimosti ot tiazhesti porazheniia koronarnykh arterii i stepeni revaskuliarizatsii miokarda.

Long-term results of aortocoronary shunting are reviewed in 219 coronary patients with reference to the severity of coronary arterial damage and myocardial revascularization. Functional class of angina pectoris declined 2.5-fold postoperatively and was 1.6 +/- 0.14 at long-term follow-up. The success rate reached 74%. Survival rate was 87.3%, including hospital mortality, and long-term survival was 92.1%. Acute coronary insufficiency was the principal cause of compromised success and survival rates. The operation was particularly effective in patients with first- or second-degree total coronary arterial lesion and true complete myocardial revascularization.

[Diagnostic significance of late ventricular potentials]. / Diagnosticheskoe znachenie pozdnikh potentsialov zheludochkov serdtsa.

A study using two methods of noninvasive registration of ventricular late potentials (VLP), computer averaging and beat-to-beat spatial averaging, was conducted in 27 patients with ventricular tachycardia and 11 healthy volunteers. Both techniques are described in detail. The duration of QRS complex on high resolution ECG was found to be significantly longer in patients with VLP as compared to those of patients without VLP and having ventricular tachycardia as well as healthy adults. The data obtained by both methods do not differ significantly. The beat-to-beat method was not informative in about 20% of cases because of the ineffective filtering procedure and the presence of myographic noise on the amplified CS. The duration of VLP was 44 +/- 20 ms in patients with documented ventricular tachycardia. The sensitivity of the assessment of arrhythmogenic ventricular activity was 70% with the computer method, and 59% with the beat-to-beat spatial averaging technique. The specificity and predictive value of both registration methods were 100%.