[Surgical treatment of Taussig-Bing anomaly in children in the first year of life].

The history of surgical treatment, clinical features, and main variants of correction of Taussig-Bing anomaly in children during the first year of life is briefly reviewed including original data obtained in the Department of Urgent Surgery of newborn and first-year infants, A. N. Bakulev Research Centre of Cardiovascular Surgery for the period of 2000-2006.

[The use of modified ultrafiltration in correcting complex congenital heart defects in newborn and nursing infants]. / Primenenie modifitsirovannoi ul'trafil'tratsii pri korrektsii slozhnykh vrozhdennykh porokov serdtsa u novorozhdennykh i grudnykh detei.

Modified ultrafiltration (MUF) was used in radical correction of complex congenital heart disease in 61 newborns and infants. The children were divided into 2 groups: group 1, 46 patients subjected to MUF, and group 2, 15 children operated on without MUF. Hemodynamic, hematological, biochemical, and immunological parameters were monitored. MUF in the newborns and infants helped adequately correct the hemohydrobalance due to ultrafiltration in the patient and hemoconcentration of the remaining volume in artificial ventilation device; it normalized the hematocrit values without additional infusion of donor blood. Elimination of inflammation mediators and cytokines recommends MUF for the treatment of newborns and infants.

[Anatomic correction of transposition of the great arteries in infants:experience of the first 10 operations]. / Anatomicheskaia korrektsiia transpozitsii magistral'nykh arterii u grudnykh detei: opyt pervykh 10 operatsii.

In the period March 1992 to January 1993, ten patients with transposition of great arteries (TGV) whose age ranged from 9 days to 8 months and body weight 3.2 to 7.2 kg were operated on using the arterial switch. A single-stage anatomic correction was made in 2 patients with patent arterial duct, 4 with ventricular septal defect (VSD), one with multiple VSD. Three patients with common TGA underwent correction in 2 stages: arterial switch followed prior constriction of the pulmonary artery switch followed prior constriction of the pulmonary artery and subclavian-pulmonary anastomosis. In all cases of single VSD, it was closed with a flap made from the Gore-Tex material. In the whole series of operations, 2 patients died: one being on the operating table due to anesthesiological errors, the other due to coronary blood flow disorder 3 hours after surgery. Six of the 8 discharged patients were followed 3-8 months after surgery. Two patients needed digitalis. No sign of myocardial ischemia was detected in antibody. All the patients were found to have normal left ventricular pump function. These surgeries are the first in our country and so our little experience may be of interest for national specialists.

[Splenic perfusion in the combined treatment of patients with systemic lupus erythematosus]. / Splenoperfuziia v kompleksnom lechenii bol'nykh sistemnoi krasnoi volchankoi.

Twenty patients suffering from severe systemic lupus erythematosus (SLE) underwent 52 sessions of splenoperfusion (SP) by means of extracorporeal perfusion of the patient's blood through isolated porcine spleen. It got prepared directly before the perfusion. The organ was obtained from a healthy animal in sterile conditions, washed from the blood after cannulation of the artery and vein. The patient's blood was pumped from the peripheral vein to the spleen artery. After passing through the splenic vascular bed the blood outflew from the spleen vein into the opposite peripheral vein of the patient. SP was followed by positive clinical changes: normalization of body temperature, regression of skin symptoms and articular syndrome, reduction of lymphadenopathy, hepato- and splenomegaly. The tests indicated inhibition of SLE activity. Sp-related immunocorrective effect was also present as shown by depression of B-cell hyperreactivity and T-cell immunity stimulation. 1-4-year follow-up of 19 patients showed them to be in remission. The data obtained favour SP inclusion into intensive therapy of severe SLE.

[Xenogeneic splenic perfusion in the treatment of bronchial asthma patients]. / Ksenosplenoperfuziia v lechenii bol'nykh bronkhial'noi astmoi.

Blood morphology, external respiratory function, central hemodynamics, cellular and humoral immunity, circulating immune complexes, average molecules and leucocytic index were examined in 40 patients with a severe and average severe course of infection-dependent bronchial asthma before and after xenosplenoperfusion. Positive clinical results were noted manifested in an increase of the immune reactivity, improvement of external respiratory function. The method should be used with care due to additional sensibilization of the patient and possible bronchospasm.

[The treatment of infectious-allergic bronchial asthma by the extracorporeal connection of a donor spleen]. / Lechenie infektsionno-allergicheskoi bronkhial'noi astmy metodom ékstrakorporal'nogo podkliucheniia donorskoi selezenki.

A total of 25 patients suffering from infective allergic bronchial asthma underwent extracorporeal connection of the donor's spleen (ECCDS). Before ECCDS was made the health status was unstable in all the patients, with asphyxia attacks occurring fairly often, namely up to 12 times a day. Nine patients received the maintenance therapy with steroid hormones. After ECCDS 23 persons (92%) manifested complete disappearance of asphyxia attacks or considerable abatement of their severity and rate. In all the steroid-dependent patients, the daily dosage of steroids could be lowered, while in 3 patients, hormonal drugs were afterwards discontinued. Examination of external respiratory function demonstrated the improvement of bronchial patency at the level of large, medium-size and small bronchi. There was a decrease of the concentration of the circulating immune complexes and IgE in the blood plasma. During 2 years of the follow up, 16 patients did not show any disease relapses, whereas the remainder demonstrated less gravity of attacks as compared to the period preceding the use of ECCDS. It is concluded that the use of ECCDS is desirable in the multimodality treatment of infective allergic bronchial asthma.

[Radical correction of tetralogy of Fallot in infants under 1 year of age]. / Radikal'naia korrektsiia tetrady Fallo u detei pervogo goda zhizni.

The article generalizes the experience in surgical treatment of Fallot's tetrad in 20 infants. Radical correction of the anomaly was carried out under extracorporeal circulation and deep hypothermia with reduced volume rate of perfusion. Plastics of the conus arteriosus alone was performed in 6 patients, transanulus and the pulmonary trunk in 4 patients. Two patients died, the hospital lethality was 10%. A clinical effect was produced in all the other patients. The relation of systolic pressure in the left ventricle to that in the right ventricle was 0.56 +/- 0.1, the systolic pressure gradient between the right ventricle and the pulmonary artery was 18 +/- 4.2 mm Hg. Various degree of regurgitation at the pulmonary valve was revealed after the operation in all patients. It was maximum (34 +/- 10%) in transanulus plastics.

[The effect of splenic factors on the course of the autoimmune process in New Zealand mice]. / Vliianie selezenochnykh faktorov na techenie autoimmunnogo protsessa u novozelandskikh myshei.

To exert an effect on the autoimmune process in 54 New Zealand mice aged 6 and 10 months, 0.2 ml of a solution obtained in perfusion of isolated pig's spleen (perfusate) was injected intravenously at intervals of 2--3 days (a total of 8 injections). The control group (43 mice) received injections of an isotonic buffer solution in the same regimen. After the end of perfusate administration the number of antibodies to DNA and the level of circulating immune complexes (IC) reduced markedly in the blood of the experimental mice as compared to these values in the control group. Kidney immunofluorescence demonstrated reduced number of IC deposits in the glomeruli of 6- and 10-month old mice of the experimental group. The perfusate contributes, probably, to intensified excretion of IC from the blood flow and kidneys of the experimental mice.

[Elimination of immune complex deposits from the kidneys of autoimmune NZB/N mice administered a xeno-spleen perfusate]. / Eliminatsiia otlozhenii immunnykh kompleksov iz pochek autoimmunnykh myshei NZB/N pri vvedenii perfuzata ksenoselezenki.

54 autoimmune NZB/N mice, 6 and 10 months of age, were intravenously injected 0.2 ml solution prepared during perfusion of the isolated sheep spleen with a buffer solution. Perfusion solution was injected 8 times with 2-3-day intervals. The control group of 43 mice received intravenously 0.2 ml of a buffer solution in the similar manner. After the treatment the levels of anti-DNA antibodies and circulating immune complexes were significantly decreased in the sera of mice which received the perfusion solution, as compared with the levels of control groups. Immunofluorescent studies showed a marked decrease in the number of glomerular immune complexes deposits in mice treated with perfusion solution. Six- and ten-month old mice exhibited a similar effect. The perfusion solution may be capable of eliminating the immune complexes from the blood and kidneys of autoimmune mice.

[Clinical evaluation of by-pass circulation in the early postoperative period after open heart surgery]. / Klinicheskaia otsenka vspomogatel'nogo krovoobrashcheniia v rannem posleoperatsionnom periode posle vmeshatel'stv na otkrytom serdtse.

On the basis of an analysis of results of the subsidiary blood circulation in the development of acute cardiac insufficiency or for its prevention in 68 patients in the early postoperative period after correction of rheumatic heart disease the authors give a positive assessment of this method in patients with a high degree of the operation risk.