RESUMO
An experience with treatment of 149 patients with severe injuries of the ankle joint operated using constructions of titanium-nickelide and autotransplant from the iliac crest is presented. Porous NiTi being bio-inert to organism tissues, having high through porosity, the formation of consolidation of the fracture develops more rapidly. Application of porous NiTi allowed the period of disablement to be on an average 20 days shorter and long-term results to be reliably better.
Assuntos
Artroplastia de Substituição/métodos , Calcâneo , Fixação Interna de Fraturas , Fraturas Ósseas , Níquel , Próteses e Implantes , Titânio , Transplante Autólogo , Idoso , Calcâneo/lesões , Calcâneo/fisiopatologia , Calcâneo/cirurgia , Pesquisa Comparativa da Efetividade , Feminino , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Consolidação da Fratura , Fraturas Ósseas/fisiopatologia , Fraturas Ósseas/cirurgia , Fraturas Fechadas , Humanos , Fraturas Intra-Articulares , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Fatores de Tempo , Transplante Autólogo/efeitos adversos , Transplante Autólogo/métodos , Resultado do TratamentoRESUMO
Recentemente diferentes princípios têm sido utilizado para estimular o coraçäo na tentativa de recuperar o débito cardíaco. Neste estudo multicêntrico, foram comparadas as respostas à estimulaçäo por 4 tipos de sensores, sendo 3 tipos de resposta de alça aberta (atividade física, acelerômetro e temperatura venosa central) implantados em 30 (SSIR-8 e DDDR-22), 9(SSIR-5 e DDDR-4) e 12 (SSIR) pacientes respectivamente. Um outro sensor do tipo alça fechada, sensível às variaçöes do sitema nervoso autôno, foi implantado em 57 pacientes, todos no modo DDDR. Os resultados obtidos durante a realizaçäo de atividade física diária, de teste ergométrico e de Holter de 24 horas foram comparados sendo possível observar uma maior fidelidade na curva de resposta de frequência frente a atividade física, nos pacientes submetidos à estimulaçäo de alça fechada
Assuntos
Estimulação Cardíaca Artificial , Frequência Cardíaca , Marca-Passo ArtificialRESUMO
The implantation of a home programmed device "ECS-500" was performed in 121 patients with different disturbances of the cardiac rhythm. Programmed ECSs were used in 103 patients with echocardiography and integral rheography. Seventy six patients were observed in terms from 2 months to 1.5 year. Optimum frequencies of electrostimulation (ES) were determined for different groups of patients. Lower frequencies of ES allowed to lessen manifestations of angina pectoris in patients with ischemic heart disease. Higher amplitude of the impulse prevented reoperations in 4 patients with "block of output" of electrodes. The experience allows "ECS-500" to be recommended for introduction into clinical practice.
Assuntos
Bloqueio Cardíaco/terapia , Frequência Cardíaca/fisiologia , Marca-Passo Artificial , Síndrome do Nó Sinusal/terapia , Taquicardia Supraventricular/terapia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Eletrocardiografia , Eletrodos Implantados , Feminino , Bloqueio Cardíaco/fisiopatologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Síndrome do Nó Sinusal/fisiopatologia , Taquicardia Supraventricular/fisiopatologia , Fatores de TempoRESUMO
One case of a rare complication of the permanent heart electrostimulation is observed among many patients treated with such method for many years. A 77-year-old man having a permanent electrostimulation during 13 years because of a complete atrioventricular heart blockade, developed a defect of the tricuspid valve resulting from two endocardial electrodes. Narrowing of the right atrioventricular aperture and a severe dilatation of the right atrium worsened the circulation deficiency. More frequent use of various methods of the nonfunctioning endocardial electrode elimination is recommended. Transvenous destruction of the fibrous capsule at the end of endocardial electrodes is an efficient method developed by the authors for their elimination.
Assuntos
Doença Iatrogênica , Marca-Passo Artificial , Valva Tricúspide/lesões , Idoso , Doença Crônica , Eletrodos Implantados , Bloqueio Cardíaco/complicações , Bloqueio Cardíaco/patologia , Bloqueio Cardíaco/terapia , Humanos , Masculino , Valva Tricúspide/patologiaRESUMO
Thirty-two patients with disturbed atrioventricular conduction underwent operation for continuous P-wave electrostimulation (ES) with implantation of Soviet-made serial KC-320 apparatuses by the myocardial (28 patients) and endocardial (4 patients) methods. The patients were examined in postoperative periods of 3 to 15 months. Stable bio-controlled ES with a good clinical result was recorded in 29 patients, dislocation of the atrial endocardial electrode--in one patient; the development of frequent paroxysms of atrial flutter-fibrillation made it necessary to change the ES regimen. The authors' experience allows KC-320 to be recommended in wide clinical practice.
Assuntos
Bloqueio Cardíaco/terapia , Marca-Passo Artificial , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Continuous atrial (73) or ventricular (77) electrostimulation, alone or combined with transvenous endocardial electrodestruction of the AV junction (24) was performed in 150 patients with sick sinus syndrome (SSS). Five-year follow-up of 148 patients identified groups of patients with impaired atrioventricular conductivity and bradytachy-arrhythmic SSS syndrome. Prolonged atrial electrostimulation is shown to be possible in cases of moderately impaired atrioventricular conductivity. Antiarrhythmic efficiency of atrial and ventricular electrostimulation was found to be insufficient for the prevention of atrial fibrillation paroxysms. It is concluded that transvenous electrodestruction of the atrioventricular junction in combination with ventricular electrostimulation is highly effective in cases of bradytachy-arrhythmic SSS syndrome. Surgical strategy is proposed for different types of the SSS syndrome.
Assuntos
Estimulação Cardíaca Artificial/métodos , Bloqueio Cardíaco/terapia , Síndrome do Nó Sinusal/terapia , Taquicardia Paroxística/terapia , Taquicardia Supraventricular/terapia , Adulto , Idoso , Feminino , Átrios do Coração , Bloqueio Cardíaco/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Nó Sinusal/complicações , Taquicardia Paroxística/etiologia , Taquicardia Supraventricular/etiologiaRESUMO
Long-term results of continuous atrial pacing were assessed in 100 patients with sick sinus syndrome followed up for 6 years. Implantation of the pacemaker was performed via extrapleural and extraperitoneal approaches using serial myocardial non-suture electrodes. Antiarrhythmic efficacy of atrial pacing was found insufficient. Continuous atrial pacing proved advantageous only in Wenckebach point at 100-120 per min.
Assuntos
Marca-Passo Artificial , Síndrome do Nó Sinusal/terapia , Seguimentos , HumanosRESUMO
Under study were 3 kinds of national sutureless myocardial electrodes compared with sutured electrodes. Sutureless electrodes were simply and reliably implanted into the ventricles and right auricle of the heart, they had better biophysical properties than sutured electrodes. The application of sutureless electrodes and special elevator of the breast bone allows to decrease the duration and traumatism of operations of myocardial electrocardiostimulation, lethality can be reduced to 1%, the amount of hospital complications to 5%.
Assuntos
Arritmias Cardíacas/terapia , Marca-Passo Artificial , Adulto , Idoso , Eletrodos Implantados , Feminino , Átrios do Coração/cirurgia , Ventrículos do Coração/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Sutura , U.R.S.S.RESUMO
The paper is concerned with the results and analysis of transesophageal electrocardiostimulation in 383 patients before and in hospital over 6 years for urgent therapy of brady- and tachyarrhythmias. The method was assessed using a simple, recoverable and effective first aid element in combined resuscitation measures, in therapy of paroxysms of supraventricular tachycardia, in patients with the sinoatrial node weakness syndrome during cardioversion and narcosis, in primary and repeated pacemaker implantations, in acute myocardial infarctions complicated by bradyarrhythmias. Transesophageal electrocardiostimulation in urgent therapy of bradyarrhythmias, the sinoatrial node weakness syndrome, disorders of permanent electrocardiostimulation with fits of Morgagni-Adams-Stokes syndrome is an uncomplicated method of choice and a stage before temporary endocardial and permanent electrocardiostimulation.
Assuntos
Arritmias Cardíacas/terapia , Marca-Passo Artificial , Síndrome de Adams-Stokes/terapia , Bradicardia/terapia , Emergências , Esôfago , Primeiros Socorros , Humanos , Síndrome do Nó Sinusal/terapia , Taquicardia/terapiaRESUMO
Forty-four patients with the syndrome of pacemaker weakness were subjected to the operation of the continuous electrostimulation of the right atrium from the infrasternal access using sutureless electrodes. Patients with grave attendant diseases were shown to benefit from this procedure. The use of Soviet commercially available sutureless electrodes makes it possible to considerably simplify the main stage of the operation and to ensure the reliable functioning of the biocontrolled cardiostimulators at the long-term postoperative period.