[Immediate and late results of transluminal balloon angioplasty of Blalock-Taussig stenosing anastomosis in cyanotic congenital heart defects]. / Neposredstvennye i otdalennye rezul'taty transliuminal'noi ballonnoi angioplastiki stenozirovannogo anastomoza Bleloka-Taussig pri tsianoticheskikh vrozhdennykh porokakh serdtsa.

Transluminal balloon angioplasty of Blalock-Taussig's stenotic anastomosis was performed in 37 patients with various congenital heart diseases in 1989 to April 1993. The patients' age ranged from 3 to 16 years (mean 8.4 +/- 0.5 years). Arterial blood oxygen saturation varied from 38 to 74% (mean 62.4 +/- 1.5%). Hemoglobin amounted to 14 to 28.4 g% (mean 19.0 +/- 8.4 g%). Phonocardiography recorded no or low-amplitude systolic-diastolic anastomosis murmur in points IV-V in all patients. After balloon anastomosis dilatation, arterial blood oxygen saturation increased, on an average, from 62.4 +/- 1.5% to 81.2 +/- 1.2%. Anastomosis angiometry performed prior to and following balloon dilatation showed its significant dilatation (on an average, from 3.39 +/- 0.19 to 5.26 +/- 0.24 mm). There was a distinct systolic-diastolic murmur of anastomosis on the PhCG. Post-balloon-dilatation complications occurred only in 3 cases: femoral thrombosis in 2 patients and pulmonary edema in 1. The late results were studied in 18 patients at months 2 to 40. None of them showed deterioration of clinical results after balloon dilatation. Eight patients were radically operated on. The best results were achieved in patients with discrete anastomosis stenoses and when balloons whose diameter corresponded to that of the subclavian artery and equal to 0.92-1.2 mm were used. A good effect following balloon angioplasty was observed in 24 (64.9%), satisfactory and poor results were found in 12 (32.4%) and 1 (2.7%), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[The percutaneous transluminal balloon valvuloplasty of valvular stenosis of the pulmonary artery in treating tetralogy of Fallot as an alternative to the surgery of applying a systemic-pulmonary anastomosis]. / Chreskozhnaia transliuminal'naia ballonnaia val'vuloplastika klapannogo stenoza legochnoi arterii pri lechenii tetrady Fallo kak al'ternativa operatsii nalozheniia sistemno-legochnogo anastomoza.

From January 1991 to May 1992 transluminal balloon valvuloplasty [correction of vulvoplasty] of severe valvular stenosis of the pulmonary artery was performed in 14 patients with Fallot's tetrad at the Institute of Cardiovascular Surgery named after A. N. Bakulev. Five of them had pulmonary artery hypoplasia, 2 had stenosis and hypofunction of the systemic-pulmonary anastomosis applied by the Blalock-Taussig, which made them perform balloon angioplasty of the narrowed distal portion of the anastomosis. The patients' age ranged from 11 months to 14 years (mean age 6.8 +/- 1.1 years). Arterial blood oxygen saturation varied from 51 to 72% (mean 69.2 +/- 2.4%). The diameter of a valvular ring was 8-13 mm. The diameter of a balloon catheter exceeded that of the valvular ring by 20-25%. After dilation, arterial blood oxygen saturation increased from 69.86 +/- 2.5 to 85.1 +/- 1.2%. The angiometry performed after pulmonary artery valvuloplasty in patients with pulmonary hypoplasia showed an increase in sizes of all pulmonary arterial segments on an average by 22.5 +/- 4.1%. Later on 5 patients were radically operated on. Thus, with the ultimate goal of preparation of patients with severe Fallot's tetrad for radical surgery, transluminal balloon valvuloplasty in some patients with severe valvular stenosis of the pulmonary artery may be alternative to a systemic-pulmonary anastomosing operation.

[The transluminal balloon angioplasty of a stenosed Blalock-Taussig systemic-pulmonary anastomosis in congenital heart defects of the blue type]. / Transliuminal'naia ballonnaia angioplastika stenozirovannogo sistemno-legochnogo anastomoza po Bleloku--Taussig pri vrozhdennykh porokakh serdtsa sinego tipa.

Dilatation of a stenosed Blalock-Taussig anastomosis was performed in 15 patients with blue-type congenital heart diseases at the Bakulev Institute of Cardiovascular Surgery, AMS USSR, from March, 1989 to May, 1991. Seven of these patients had a severe form of Fallot's tetralogy, 4--double origin of the great vessels from the right ventricle with stenosis of the pulmonary artery, 2--atresia of the right atrioventricular orifice with stenosis of the pulmonary artery, 1--atresia of the right atrioventricular orifice with atresia of the pulmonary artery, and 1 patient had corrected transposition of the great vessels with stenosis of the pulmonary artery. The patients' ages ranged from 4 to 13 years (9.45 +/- 8.1 years on the average). Saturation of arterial blood with oxygen varied from 38 to 77% (64.2 +/- 2.9% on the average). A low-amplitude to-and-fro sound of the anastomosis was either recorded or absent on the phonocardiogram. The diameter of the balloons used ranged from 4 to 13 mm. Inflation of the balloon lasted from 5 to 60 sec. Dilatation was conducted 3 to 9 times. After dilatation saturation of arterial blood with oxygen increased to 81 +/- 2.7% on the average. A clearly defined to-and-fro murmur of the anastomosis was recorded on the phonocardiogram. Angiometry of the anastomosis performed before and after dilatation showed it to be widened considerably from 3.5 +/- 0.2 mm to 5.7 +/- 0.4 mm on the average. One patient underwent a radical operation 8 months after balloon dilatation.

[Assessment of patients' condition by noninvasive methods of examination in the follow-up after Fontan's operation in atresia of the right atrioventricular ostium]. / Otsenka sostoianiia bol'nykh s pomoshch'iu neinvazivnykh metodov issledovaniia v otdalennye sroki posle operatsii Fontena pri atrezii pravogo atrioventrikuliarnogo otverstiia.

The article discusses the results of using noninvasive methods to study the condition of patients (20) in late-term periods after Fonten's operation in atresia of the right atrioventricular orifice. All patients were subjected to physical examination, electro-, phono- and echocardiography, radiological examination, radioisotope scintigraphy, and left ventriculography. Most patients change to functional class I in the late-term periods after the operation. Though the patients have a sense of well being, the left-ventricular pumping and contractile functions remain disturbed. A tendency towards gradual improvement of these parameters is noted, however. The right atrium is enlarged and its myocardium hypertrophied. Its overexertion increases significantly in physical loading. The blood flow in the lungs becomes normal gradually. The results of various noninvasive methods correlate with one another and with the results of angiocardiography. This allows in some cases to avoid intracardiac examination which presents a certain risk, especially in the first one-two years after Fonten's operation when the mechanisms of cardiac activity compensation are still weak.

[Hemodynamic mechanisms of ECG changes in congenital fistulas of the coronary arteries]. / Gemodinamicheskie mekhanizmy izmeneniia EKG pri vrozhdennykh fistulakh koronarnykh arterii.

ECG changes were analysed in 31 patients with congenital coronary arterial fistulas with reference to the site of coronary arterial lesion and the level and magnitude of blood discharge. Two hemodynamic factors, conditioning ECG changes, were identified as typical for coronary arterial fistulas: 1) volume strain on cardiac compartments making up the fistula receptacle chamber; 2) perfusion deficiency in the distal segment of the affected coronary artery. Fistulas with large-volume shunts may be accompanied by both ischemic changes in the affected-artery basin and regional perfusion disorders in adjacent basins, the latter being due to "stealing" of the adjoining coronary trunk or the type of coronary blood supply.

[Electrocardiographic characteristics of an anomalous origin of the left coronary artery from the pulmonary trunk]. / Elektrokardiograficheskaia kharakteristika anomal'nogo otkhozhdeniia levoi koronarnoi arterii ot legochnogo stvola.

Electrocardiographic characteristics of abnormal left coronary arterial branching (ALCAB) from the pulmonary trunk were examined in 36 patients, aged 2 months to 39 years. Signs of marked left-ventricular and left-atrial overstrain were typical for all ages. There were signs of past left ventricular myocardial infarction in 88.8% of patients, the cicatricial changes being anterolateral in 65.6%, which is typical for the defect. The follow-up of ECG pattern over 1 month to 8 years after the defect was first detected demonstrated that coronary circulation deteriorated in 64.3% of cases.

[Electrocardiographic diagnosis of the open oblique atrioventricular canal]. / Elektrokardiograficheskaia diagnostika otkrytogo kosogo atrioventrikuliarnogo kanala.

The article is devoted to the detection of ECG criteria characteristic of the open oblique atrioventricular canal which makes it possible to make the differential diagnosis not only between individual forms of the open oblique atrioventricular canal but also to differentiate it from other forms of congenital heart disease.

[Electro- and phonocardiographic diagnosis of interventricular septal defect associated with aortic insufficiency]. / Elektro- i fonokardiograficheskaia diagnostika defekta mezhzheludochkovoi peregorodki v sochetanii s aortal'noi nedostatochnost'iu.

Fifty-two post-surgery patients were studied for signs of interventricular septum defect in conjunction with aortal failure. The basic relevant signs were established to be insulated hypertrophy of the left ventricle or combined hypertrophy of both ventricles (with the left one being dominant) in conjunction with high amplitude pansystolic sounds and the presence of decreasing diastolic noise of aortal insufficiency, lagging behind tone II with the epicentre in points V-IV. The above signs may be used in the differential diagnosis of such congenital heart disease as an open arterial canal, rupture of Valsalva's sinus aneurysm into the right ventricular cavity coronary fistula and aortopulmonary septum defects.

[Electrocardiographic diagnosis of patent ductus atrio-ventricularis]. / Elektrokardiograficheskaia diagnostika otkrytogo atrio-ventrikuliarnogo kanala

The paper deals with the diagnosis of defective development of the patent ductus atrioventricularis. Electrocardiographic changes in 81 patients with firmly established hemodynamic form of the patent ductus atrioventricularis, ascertained during surgery and catheterization, are summarized. Characteristic electrocardiographic signs of the defect distinguishing it from other congenital diseases and differential-diagnostic symptoms of diverse anatomo-hemodynamic forms of the patent ductus atrioventricularis were educed.

[Electro- and phonocardiographic changes in cases of a common arterial trunk]. / Elektro- i fonokardiograficheskie izmeneniia pri obshchem arterial'nom stvole

Analysing the data of the examination of 27 patients with a common arterial duct the authors studied the phono- and electrocardiographic changes observed in this cardiac defect. The probable phono- and electrocardiographic signs of this pathology are described the criteria that permit to suspect the presence of a common arterial duct are presented.