[The biocompatibility testing of various types of nonorganic implants].

Impact of living organism on nonorganic materials, which are applied for the implants manufacturing, was studied. There was established, that organism of a recipient patient actively effects on exogenic material, destroying its superficial layer and forming the connective tissue capsule around the implant. The implant surface may start to dissolve selectively as a result of aseptic inflammation, keeping around, in such a situation it become necessary to remove the prostheses, which have lost their function. Impact of organism on surface of different implants of nonorganic origin and the ways of it prophylaxis were investigated. Instrumental method of the preoperative compatibility testing between a recipient organism and the implant material, using the atomic-power microscope, was proposed.

[Remote results of endoprosthesis of the infrarenal aorta aneurysm].

Endovascular endoprosthesis of infrarenal aorta aneurysm (EEIAA)--is miniinvasive highly technological method of treatment of a life-threatening disease. The rate of the endovascular interventions conduction for aortal aneurysm enhances every year in the world, the prosthesis construction and operative technique are upgrading constantly. The experience of the EEIAA endoprosthesis in 75 patients, aged 51-80 years old, 70 men and 5 women, was presented. The aneurysm size was from 4.3 to 8 cm. Preoperative examination of the patients have included the ultrasound scanning, computeric tomography (CT). Among existing complications there is haemorrhage from the access site more than 500 ml in volume, demanding the erythrocytic mass transfusion in 2 patients. The patients were followed up from 1 mo till 7 yrs. A hospital lethality was absent. Major cardiovascular accidents in the terms of observation up to 30 days postoperatively were absent. During the follow up period the mortality, connected immediately with the abdominal aorta aneurysm rupture, was absent.

[Anesthesiological support during performance of endovascular prosthesis for the infrarenal aorta aneurysm].

The results of treatment of 10 patients, suffering the abdominal aorta aneurysm, using the third generation bifurcational prosthesis Excluder, are presented. Endoprosthesis was performed under local infiltrating anesthesia (LIA) and light sedation, in one observation the LIA was incidentally changed to general anesthesia and artificial lung ventilation. In the early postoperative period the complications did not occur. LIA may be successfully applied if the patient was thoroughly prepared and informed, the arteries were accurately dissected and intravascular apparatuses inserted, as well as the performance of the aorta endoprosthesis for the abdominal aorta aneurysm was not durable.

[Prophylaxis and treatment of a pulmonary artery thromboembolism]. / Profilaktika i lechenie tromboémbolii legochnoi arterii.

Experience of treatment of 103 patients with an acute thromboembolism (TE) of a. pulmonalis (AP) was analyzed. According to clinic, angiographical and hemodynamical investigations data the indications for performance of operative and conservative treatment depending on degree of the pulmonary blood flow disorder were substantiated. Comparative analysis of results of treatment of TEAP using different thromboembolic preparations was conducted. Efficacy of thrombolysis depends on time passed away from moment of lesion. In 69% patients thromboembolectomy is effective.

[Application of clexane for prophylaxis of thromboembolic complications in surgery of morbid obesity]. / Primenenie kleksana dlia profilaktiki tromboémbolicheskikh oslozhnenii v khirurgii patologicheskogo ozhireniia.

The results of comparative clinical application of low-molecular heparin Clexan vs heparin for the thromboembolic complications prophylaxis in surgical treatment of morbid obesity were summarized.

[Simultaneous revascularization of the myocardium and lower extremities due to dissipated atherosclerosis]. / Odnovremennaia revaskuliarizatsiia miokarda i nizhnikh konechnostei po povodu rasprostranennogo ateroskleroza.

In 18 patients with the cardiac coronary arteries and the lower extremities main arteries atherosclerotic affection the simultaneous aortocoronary shunting in concurrence with the lower extremities revascularization were conducted. The mortality was 5.5%.

[The evaluation of the elastic properties of the arterial wall by ultrasonic study data in patients with atherosclerotic vascular lesions]. / Otsenka élasticheskikh svoistv arterial'noi stenki po dannym ul'trazvukovogo issledovaniia u bol'nykh s ateroskleroticheskim porazheniem sosudov.

Ultrasonic scanning method in a real scale of time was used in examination of 10 patients with abdominal aorta (AA) aneurysm, 10-with arterial hypertension (AH), 10-with obliterating atherosclerosis of the lower extremities vessels (OALEV) without AH and practically healthy controls aged 32-45 years. AA aneurysm and OALEV diagnosis was made according to the ultrasonic investigation and roentgen-contrast angiography data obtained. The statistically significant (P < 0.05) reduce of AA wall distentivity and its rigidity increase was disclosed while there were no differences of the values of vessel diameter, normalized for the body surface square, determined by the measured magnitude of the relative vessels deformation caused by the pulse change in arterial pressure. The changes of the vascular wall elastic-viscositive properties in patients with OALEV and AH were directed similarly but they lacked intensity. The AA aneurysm magnitude did not correlate with the degree of vascular wall distentivity (r = 0.46).

[Surgical treatment of multiple occlusions of the aortic arch arteries]. / Khirurgicheskoe lechenie mnozhestvennogo okkliuzionnogo porazheniia arterii dugi aorty.

The results of treatment of 174 patients with lesions of the arteries of the aortic arch are presented. Multiple lesions of the coronary arteries were revealed in 78 patients, of the brachiocephalic trunk--in 45, their combination--in 52. In patients with the ischemic heart disease, in average, 3,4 aortocoronary shunts were placed. In patients with the impaired cerebral circulation, reconstruction of 2-3 arteries was performed simultaneously in their unilateral lesions. In case of their bilateral lesions, the blood flow restoration was performed in two stages with a 2-4 week interval. Improvement of the indices of intravascular hemodynamics was achieved in 97.5% of the patients, neurologic symptoms were completely eliminated in 71% of the patients. Three patients died from cardio-vascular failure.

[The therapeutic procedure in thromboembolism of the pulmonary artery]. / Lechebnaia taktika pri tromboémbolii legochnoi arterii.

Clinical symptomatology, ECG, roentgenography, echocardiography, blood biochemistry, angiopulmonography with manometry of the pulmonary artery and right heart compartments were used to diagnose in 14 patients (age: 25-65 years) massive and submassive pulmonary artery thromboembolism. The angiopulmonographic index exceeded 18 points. Treatment included embolectomy, medical therapy (heparine, indirect anticoagulants), thrombolytic agents (celiase) and symptomatic therapy. The results of medical treatment were good in 80% of patients. Good results in embolectomy were observed in 77.7%. The authors formulate absolute and relative indications to urgent embolectomy in conditions of artificial circulation.

[Intragastric blood flow in the etiology of duodenal ulcer--new aspects of surgical treatment]. / Vnutrizheludochnyi krovotok v étiologii iazvennoi bolezni dvenadtsatiperstnoi kishki--novye aspekty khirurgicheskogo lecheniia.

In the experiment on dogs and in patients with duodenal ulcer disease, it was established that the regulation of acid production besides the vagal nerves was mediated by the intragastric gastrin transport with the blood flow. A method of preoperative diagnosis of the intensity of intragastric blood flow permitting to define more accurately the indications for the choice of a method for surgical treatment has been developed. Supplementation of the selective proximal vagotomy with circular mucosectomy at the boundary between the antrum and body of a stomach enhances the effectiveness of operation due to reduction of the antral gastrin influence on the acid-producing zones of the stomach.