[Hemodynamic results of replacing the mitral valve with an aortic xenobioprosthesis]. / Gemodinamicheskie rezul'taty zameny mitral'nogo klapana aortal'nym ksenobioprotezom.

Results of an analysis of clinico-hemodynamic data obtained in 66 patients with bioprosthesis of the mitral valve are presented. The data of intraoperative examination as well as of catheterization of heart cavities within the period from 6 to 62 months after operation show the xenoaortic bioprosthesis to give an adequate correction of the mitral valve defect, their implantation was followed by a substantial improvement of the patients's state.

[Angiocardiographic symptomatology and hemodynamic disorders in cardiac myxoma]. / Angiokardiograficheskaia simptomatika i narusheniia gemodinamiki pri miksomakh serdtsa.

Hemodynamic and angiocardiographic findings are analysed in 10 patients with intracardiac myxomas of varying localization: right-atrial myxoma in 1, right-ventricular myxoma in 2, left-atrial in 6, and multiple right-atrial and right-ventricular myxomas in 1. The pattern of intracardiac hemodynamic disorder depends on the site of tumour and resembles patterns associated with various valvular defects. Selective angiocardiography combined with roentgenocinematography can yield the most objective information for myxoma diagnosis.

[Assessment of myocardial contractile function in the ventricles in acquired heart defects with planned surgical treatment]. / Otsenka sokratitel'noi funktsii miokarda zheludochkov pri priobretennykh porokakh serdtsa v plane operativnogo lecheniia.

The paper analyzes haemodynamic and myocardial parameters in 200 patients with rheumatic heart diseases (mitral and aortic) obtained during catheterization of cardiac cavities and angiocardiography. A relationship of certain haemodynamic parameters with contractility disorders in the left ventricle myocardium has been established. The analysis of all the myocardial and haemodynamic changes can characterize the degree of disorders in the contractility of the myocardium. Disorders in the contractility of the left ventricle myocardium were considered as marked, with the contractility index of the left ventricle myocardium less than 850 relative units, the end diastolic pressure of 15 mm Hg and over and the ejection phase below 55%. The determination of haemodynamic and myocardial parameters and clinical data are of great importance in the evaluation of indications and contra-indications for surgical treatment of patients with valvular defects of the heart.

[Dynamics of pulmonary hypertension after mitral valve prosthesis (late results)]. / Dinamika legochnoi gipertenzii posle protezirovaniia mitral'nogo klapana (otdalennye razul'taty)

The presented analysis includes the haemodynamic parameters obtained during right and left heart catheterization in 51 patients following mitral valve prosthetic replacement for rheumatic mitral disease within 1 month to 8 years. In 30 patients the examination was conducted pre- and postoperatively, and in 21--postoperatively only. A comparative analysis of the pre- and postoperative haemodynamic indices has shown that when the effect of surgery is positive, the pressure in the pulmonary artery, the wedge pressure, the right atrial, and the end-diastolic pressures in the right and left ventricles decrease. A reduction is also noted in the pulmonary-arteriolar resistance, in the arterio-venous oxygen content gradient, and in the right ventricle work, and an increase in the cardiac output, cardiac index and effective work of the left ventricle. The dynamics of these parameters is especially dramatic in patients with severe pulmonary hypertension (the pulmonary artery pressure falls by 60%, and the pulmonary-arteriolar resistance--by 83%). When the operation fails to produce any haemodynamic effect, the intracardiac haemodynamics disorders persist along with those in the pulmonary circulation, which permits us to find the reason of the unsatisfactory result of surgery.

[Results of the aortic valve prosthesis with a follow-up period of over 3 years]. / Rezul'taty protezirovaniia aortal'nogo klapana pri sroke nabliudeniia bolee 3 let

The results of the aortic valve prosthetics in 71 patients discharged from the A.N. Bakulev institute of Cardio-Vascular Surgery of the AMS of the USSR as far back as three and more years ago are analyzed. All these patients had been given implanted a Soviet-made ball-type prosthesis, model AK4-02. In 5 patients some additional operative interventions were performed. No indirect action anticoagulants were used. Nine patients (12.7 per cent) died late after the operation. Good, persistent results were achieved in 48 cases (67.6 per cent) with follow-up period ranging from 3 to 9 years. Major causes responsible for a reduced effect of surgery were thromboembolic complications, paravalvular fistulas and also uncorrected or inadequately corrected concomitant failures of other valves. Ways of increasing the effective prosthetics of the aortic valve with the ball-type prosthesis are discussed.