[Application of sorbilact in complex correction of enteral insufficiency syndrome in surgical patients]. / Primenenie sorbilakta v kompleksnoi korrektsii sindroma énteral'noi nedostatochnosti u khirurgicheskikh bol'nykh.

The most important teoretical aspects of the enteral insufficiency syndrome formation in an acute abdominal surgical diseases were suggested. Basing on the treatment results analysis of 19 patients with different abdominal surgical diseases, using hypertonic sorbitol solution, the authors confirm high therapeutic efficacy of the preparation, administration of which have had promoted the intestinal motor function restoration and optimization, as well as adapting action of the preparation in enteral probe nutrition conduction in patients during ealy postoperative period.

[Effects of nitroglycerin on myocardial contraction in patients with ischemic heart disease]. / Vliianie nitroglitserina na sokratimost' miokarda u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The effects of nitroglycerin on central hemodynamics and direct myocardial contractility were directly studied in 32 patients with functional class III-IV heart failure during aortocoronary bypass surgery. When nitroglycerin was used, hemodynamic parameters changed in two stages: 1) systemic blood pressure initially slightly increased; 2) decreases in this and other central hemodynamic parameters occurred. The dynamics of myocardial function was determined by its baseline state, dyskinetic intensity, i.e. its contractility. In patients with preserved myocardial function, nitroglycerin failed to cause its substantial dysfunction. At the same time its contractility and central hemodynamic parameters might considerably deteriorate in patients with moderate dyskinesia and furthermore with severe myocardial dysfunction.

[Assessment of myocardial function and metabolism in patients during aortocoronary bypass surgery after hypoxia-reoxygenation]. / Otsenka funktsii i metabolizma miokarda u bol'nykh vo vremia aortokoronarnogo shuntirovaniia posle gipoksii-reoksigenatsii.

The myocardial function and metabolism were assessed in 12 patients with coronary heart disease intraoperatively during aortocoronary bypass surgery. The antioxidative properties of the blood of the heart were found to become lower along with activated peroxidation after the major stage of an arrested heart operation, that correlated with depressed myocardial function.

[Intraoperative myocardiography, a new method of regional myocardial function evaluation during aortocoronary bypass surgery]. / Intraoperatsionnaia miokardiografiia--novyi metod otsenki regionarnoi funktsii miokarda vo vremia aortokoronarnogo shuntirovaniia.

Excursions of the myocardium in its revascularization area were recorded in 70 patients with coronary heart disease. Myocardial dyskinesia correlated with low bypass blood flows, myocardial ischemia and infarction in the area of revascularization at any blood flow values. The evaluation of the diagnostic efficacy of myocardiographic symptoms suggested that myocardiography had some advantages. It was concluded that it was essential to include intraoperative myocardiography into the set of methods for examining patients with coronary heart disease during myocardial revascularizations.

[Clinico-functional correlations of left atrial myocardial excursions in patients with mitral valve defects]. / Kliniko-funktsional'nye korreliatsii kharakteristik ékskursii miokarda levogo predserdiia u bol'nykh porokami mitral'nogo klapana.

The pre- and intraoperative drug maintenance was evaluated in 50 patients with mitral valvular disease and compared with the types of left atrial myocardial excursions. The maintenance with cardiac glycosides and diuretics was greatly different in 3 groups of patients with various types of left atrial myocardial excursions. In patients with Type I excursions the maintenance was minimal, in those with Type III excursions it was maximal, those with Type II excursions, it was intermediate. It is concluded that the functional characteristics of left atrial myocardial excursions may be used as an indicator of cardiac performance.

[Clinical and functional correlations of left atrial excursion characteristics in patients with mitral valve diseases. Part II]. / Kliniko-funktsional'nye korreliatsii kharakteristik ékskursii miokarda levogo predserdiia u bol'nykh porokami mitral'nogo klapana. Soobshcheniie II.

Left atrial myocardial excursions were intraoperatively recorded in patients with mitral valvular disease (33 patients with mitral stenosis and 17 with mitral regurgitations). Three types of atrial myocardial excursions were identified. There was a high correlation between the types of myocardial excursions and the incidence of heart failure. The patients with Types I and II myocardial excursions had no virtually heart failure, those with Type III showed the highest (70%) incidence of heart failure. It is concluded that intraoperative assessment of left atrial myocardial excursions is of great significance in patients with mitral valvular disease.

[Evaluation of the diagnostic effectiveness of the indicators of left atrial myocardial function in intraoperative cardiac weakness in patients with mitral valve defects]. / Otsenka diagnosticheskoi éffektivnosti pokazatelei funktsii miokarda levogo predserdiia v otnoshenii intraoperatsionnoi serdechnoi slabosti u bol'nykh porokami mitral'nogo klapana.

Excursions of the left-atrial myocardium were recorded by tensiometric transducers in patients with mitral valvular disease. The structural features of myocardial excursions were evaluated as symptoms. Myocardial shortening in P-Q interval was considered a negative symptom in relation to heart weakness, shortening in T-Q interval as an indefinite symptom, and shortening in Q-T interval as a positive symptom. Appraisal of the sensitivity and specificity of these symptoms revealed their high diagnostic efficacy.

[Evaluation of right ventricular myocardial excursions in patients with mitral valve stenosis without pulmonary hypertension]. / Otsenka ékskursii miokarda pravogo zheludochka u bol'nykh s mitral'nym stenozom bez legochnoi gipertenzii.

As many as 23 patients with mitral stenosis were examined intraoperatively, by evaluating of intracardiac hemodynamics and right ventricle myocardial excursions. Before mitral stenosis was corrected, 56% of patients had demonstrated myocardial excursion disorders. After the correction the number of patients with myocardial dysfunction halved. The transition of patients belonging to the group with abnormal myocardial excursions to the group with normal excursions depends on the scope of surgical intervention and pharmacological support. After the correction of mitral stenosis cardiogenic and pulmonogenic complications may mostly be seen in the patients' group showing abnormal myocardial excursions. It is concluded that the symptom of abnormal right ventricle myocardial excursions is of prognostic significance with respect to the development of complications in the early postoperative period.

[Clinical and functional correlations of left-atrial myocardial excursions in patients with mitral valve defects (I)]. / Kliniko-funktsional'nye korreliatsii kharakteristik ékskursii miokarda levogo predserdiia u bol'nykh porogami mitral'nogo klapana (soobshchenie I).

Three types of atrial excursions correlating with the somatic symptoms of circulatory and respiratory dysfunctions, as well as with the degree of left atrial dilatation were intraoperatively recorded in patients with mitral valvular disease. Types I and II excursions were more common in patients with left atrioventricular stenosis, Type III in those with mitral incompetence. It is concluded that it is advisable to use left atrial myocardial excursion characteristics in the diagnosis of cardiac disease.

[Diagnosis of aortocoronary bypass complications]. / Diagnostika oslozhnenii aortokoronargnogo shuntirovania.

Thirty-four patients with ischemic heart disease were examined during operation for revascularization of the myocardium. The blood flow in the shunts was measured during the change from extracorporeal to natural circulation. In rise of venous and arterial pressure the blood flow in the shunts increased (positive dynamics) in some patients and decreased (negative dynamics) in others. Positive dynamics were associated with a favourable course of the postoperative period, negative dynamics--with ischemic-type complications. Factors invalidating the myocardium aggravated the initial condition of patients with positive dynamics of the blood flow less than that of patients with negative dynamics. Comparison of dynamic and short-term measurement of the blood flow in the shunts as a diagnostic test for perioperative complications showed the advantage of the dynamic test.

[Mitral valve prosthesis with preservation of the chordae and papillary muscles in patients with mitral insufficiency]. / Protezirovanie mitral'nogo klapana s sokhraneniem khord i papilliarnykh myshts u bol'nykh s mitral'noi nedostatochnost'iu.

Mitral valve (MV) prosthetics was performed in 14 patients in its insufficiency. In MV replacement the chordopapillary apparatus (CPA) of the posterior cusp was left intact. The EMIKS or LIKS disk prosthesis was implanted in most cases (6 and 6 patients, respectively), the biological BAKS prosthesis was implanted in 2 patient. Orientation of the large semicircumference in the direction of the anterior or posterior commissure was the optimal orientation for the disk prostheses. Measurement of the parameters of hemodynamics on the operating table showed that reduction of the rigidity of the left-ventricular myocardium and the increase of the stroke index in patients with an intact chordopapillary apparatus of the posterior cusp differed significantly from those in patients with completely excised MV. Preservation of the CPA during MV replacement in patients with mitral insufficiency leads to reduction of the rigidity of the left-ventricular myocardium and improvement of its function immediately on the operating table.

[Comparison of the characteristics of myocardial function and metabolism in patients with tetralogy of Fallot]. / Sopostavlenie kharakteristik funktsii i metabolizma miokarda u bol'nykh s tetradoi Fallo.

The authors studied the results of examination of the myocardium in patients with Fallot's tetralogy by means of two methods during radical correction of the congenital anomaly: invasive intraoperative myocardiography and appraisal of myocardial metabolism. High probability of the detection of dysfunction of the myocardium and disorders of of oxygen-dependent metabolic processes in it were revealed. A conclusion is drawn on the expediency of using invasive intraoperative myocardiography as a method of functional diagnosis in surgery of congenital heart diseases for appraising the condition of the myocardium.

[Effect of preserved subvalvular apparatus on regional left- ventricular function after mitral valve prosthesis in patients operated on for mitral insufficiency]. / Vliianie sokhranennogo podklapannogo apparata na regionarnuiu funktsiiumiokarda levogo zheludochka posle protezirovaniia mitral'nogo klapana u bol'nykh, operirovannykh po povodu mitral'no nedostatochnosti.

Mitral valve replacement with preservation of the chordo-papillary apparatus of the posterior mitral cusp was done in 24 patients with mitral valve incompetence. In nine patients, in addition to the conventional flow manometry, myocardiography was performed to study regional left ventricular myocardial contraction. For comparison, nine other patients were examined, who had been operated on for mitral valve incompetence by conventional mitral valve replacement with total resection of all its supravalvular structures. A significant difference in the improvement of left ventricular myocardial contraction was seen in patients with preserved chordo-papillary apparatus as compared with the other group. Improvement of the contractile function is believed to be secondary to enhanced myocardial compliance during the relaxation phase, rapid filling and pre-ejection. Enhanced compliance may be a factor governing the left ventricular myocardial performance.

[Evaluation of heart function using length-tension diagram in the clinical practice]. / Otsenka funktsii serdtsa s pomoshch'iu diagramm dlinna--davlenie v klinicheskoi praktike.

Simultaneous assessment of the myocardial contraction and hemodynamics showed that the absence of contraction-extension anomalies is the evidence of a current functional reserve of the cardiac muscle and depends on the external and internal factors. At the same time, a volume and resistance overload of the heart and myocardial ischemia are attended with simultaneous changes in the myocardial contraction, which testifies to a unified mechanism of circulation compensation.

[Intraoperative dynamics of the regional function of the myocardium during aortocoronary bypass]. / Intraoperatsionnaia dinamika regional'noi funktsii miokarda vo vremia aortokoronarnogo shuntirovaniia.

From the results of intraoperative examination of 50 patients with ischemic heart disease it is shown that the collateral blood flow has an essential effect on the detection of the signs of myocardial ischemia. Aortocoronary shunting leads to positive dynamics of regional myocardial function. The test with compression of the shunt may be used for indirect appraisal of the efficacy of myocardial revascularization.

[Evaluation of the functional status of the heart during aortocoronary shunting]. / Otsenka urovnei funktsional'nogo sostoianiia serdtsa vo vremia operatsii aortokoronarnogo shuntirovaniia.

Direct recording of myocardial contractility and central hemodynamic measurements were made during volumetric load tests before and after the application of aortocoronary shunts in 12 coronary patients. Aortocoronary shunting is shown to lead to a considerable rise in threshold prestress values (end diastolic volume and end diastolic pressure) associated with emerging signs of myocardial ischemia. It is suggested that cardiac functional capacity is expanded as a result of coronary flow recovery.