[Treatment of mitral valve stenosis in pregnant women by the method of balloon valvuloplasty]. / Lechenie mitral'nogo stenoza u beremennykh sposobom kateternoi ballonnoi val'vuloplastiki.

Catheter-balloon mitral valvuloplasty was performed in 7 females with rheumatic mitral stenosis on the 19th-32nd week of pregnancy. Four patients were operated on with signs of cardiac insufficiency, two--in a state of pulmonary pre-edema. Edema of the lungs in one patient continued developing on the operating table. The results of the treatment were good in all cases. The area of the mitral orifice increased from 0.9-1.75 to 2.4-3.5 cm2. The pressure gradient between the left atrium and the left ventricle dropped from 25-40 to 2-8 mm Hg. This was attended by the disappearance of the diastolic murmur and the clinical manifestations of stasis in pulmonary circulation in all patients. The development of mitral regurgitation after the operation was not encountered in any of the patients. The period of roentgenoscopy lasted 17.5 min. on the average. Screens were used to protect the fetus from the direct effect of the X-rays. Pregnancy ended in delivery in 6 patients; spontaneous labor at term occurred in 4, cesarean section had to be performed in one patient with placenta previa; one woman gave birth to twins on the 36th week of pregnancy. All the babies were healthy. Catheter-balloon valvulotomy does not yield to closed mitral commissurotomy in efficacy. The fact that it is only mildly injurious and does not need general anesthesia make this intervention preferable for pregnant women suffering from mitral stenosis.

[Microcirculatory changes in respiratory insufficiency]. / Izmeneniia mikrotsirkuliatornogo krovoobrashcheniia pri dykhatel'noi nedostatochnosti.

The paper describes the results of study of 71 patients with chronic diseases of the lungs. The methods of investigation were directed at eliciting changes in extravascular, vascular and intravascular factors of the microcirculatory system. Considerable disorders of the microcirculation have been found in respiratory insufficiency and their dependence of the stage of insufficiency. Comparison of the degree of microcirculatory shifts with the gaseous composition of the blood and the acid-base balance has been made. The stages of microcirculatory changes run parallel to the severity of respiratory insufficiency, and the causes leading to pathology of microcirculation in respiratory insufficiency are multifactorial in character, the main being changes in the gaseous composition of the blood.