[Indications and results of artificial pacemaker implantation in children]. / Pokazaniia i rezul'taty implantatsii detiam iskusstvennykh voditelei ritma.

Since 1989 till 1999 operations were performed on 74 children aged from 13 months to 15 years. There were 130 operations, 56 reoperations included. Iatrogenic atrioventricular blockades were diagnosed in 47 children (63.5%), congenital and postmyocarditic alterations in the rhythm and cardiac conductivity--in 27 children (36.5%). In 48 patients the primary implantation of electrocardiostimulators was fulfilled using myocardial electrodes, in 26 cases the endocardial method was used. Three children died at the postoperative period. The causes of death were the growing heart failure, hypoxic brain edema, ventricular fibrilation. ECG, Holter monitoring, echocardiography with dopplerography were made in the children in order to solve the question of the implantation of artificial pace-makers. At the postoperative period the electrocardiostimulators' parameters were selected individually under control of echocardiography.

[Infectious complications in electric cardiac stimulation]. / Infektsionnye oslozhneniia pri élektrokardiostimuliatsii.

There were 4424 patients operated for alterations of the cardiac rhythm. Primary electrocardiostimulation was performed in 3183 of them, reoperations in 1241 patients (39%). Infectious complications took place in 146 patients (3.3%). Based on their experiences the authors developed the strategy of treatment of patients with purulent complications and sepsis depending on their character and time of their appearance.

[Results of closed mitral commissurotomy after 20-25 years]. / Rezul'taty zakrytoi mitral'noi komissurotomii cherez 20-25 let.

The 20-25 year results of 486 closed mitral commissurotomies were analysed. The actuarial analysis demonstrated that 25-year survival was 59%, stable good results were 38%, repeated mitral interventions were performed in 31% of the patients. The patients' survival and functional results of commissurotomies depend on early surgery which should be done in patients with severe and acute mitral stenosis prior to the development of drastic valvular changes, calcinosis, regurgitation, atrial fibrillation, cardiomegaly, atrial thrombosis and other complications. Timely mitral commissurotomy is a rather effective palliative intervention in uncomplicated mitral stenosis.

[Complications and survival of patients after electric cardiac stimulation]. / Oslozhneniia i vyzhivaemost' bol'nykh pri élektrokardiostimuliatsii.

In patients with bradyarrhythmia 1105 operations were performed. Among them 528 primary stimulations were fulfilled with 2.4% lethality, 289 changes of the generator, 122 temporary electric cardiac stimulation. Complications were observed in 15.5% of the patients. Medico-technical complications took place in 5.5%, arrhythmias++--in 52.9%, purulent complications in 5.3%. Long-term results were followed-up in 405 patients within the terms from 6 months til 15 years after operation. Five years survival took place in 64.2%, ten years--in 43%, 15 years--in 27.8%. Complications in remote periods were noted in 27.6% of patients. Great attention is given to timely performed operations and dispensary observation of the patients for the improvement of results of electrocardiostimulation.

[Patient survival over 20 to 25 years after mitral commissurotomy]. / Vyzhivaemost' bol'nykh cherez 20--25 let posle mitral'noi komissurotomii.

The authors report that 282 of 457 patients (62%) are alive for 20-25 years after mitral commissurotomy. The twenty-five-year survival is higher in women (70%) than in men (30%).

[Results of 30 years' surgical treatment of acquired defects and diseases of the heart]. / Itogi 30-letiiu khirurgicheskogo lecheniia priobretennykh porokov i zabolevanii serdtsa.

A total of 11085 patients have been operated on for rheumatic heart diseases over thirty years, 85.4% of those, for mitral stenosis or its relapse, using the "closed" method (total mortality was 2.7%). In recent years, the mortality rate has dropped to 1.5% in that group of patients. Prevention of heart failure and thromboembolic complications still are the principal problem of mitral commissurotomy. Traumatic regurgitation was seen in 2%. The operation was performed under extracorporeal circulation in 6.2% of patients. Mortality, associated with mitral prosthesis implantation, has decreased threefold (to 10.8%) over 15 years. A total of 131 patients have been operated on for constrictive pericarditis, the mortality rate was 10.7%. Primary implantation of electric pacemaker for complete transverse heart block has been performed in 196 patients, and the generator was replaced in 143 patients.

[Pleural empyema after closed mitral commissurotomy]. / Empiema plevry posle zakrytoi mitral'noi komissurotomii.

Risk factors, causes and results of the treatment of 63 patients with pleura empyema after closed commissurotomy were studied. The incidence of this complication was 0,77% per 8147 operations. Among the direct causes of empyemas there were infected blood (47,6%) and exudate (41,3%) in the pleural cavity of abscessing infarction-pneumonia (9,5%). Open drainage was found to be the most effective method of the treatment. 81% of the patients recovered. Lethality was 19%, mainly due to pyo-septic complications.

[Immediate and late results of Vineberg's operation in chronic ischemic heart disease with diffuse coronary arteriosclerosis]. / Neposredstvennye i otdalennye rezul'taty operatsii Vainberga pri khronicheskoi IBS s diffuznym koronarnym aterosklerozom.

The immediate and late results of Weinberg's operation have been studied in 56 patients with chronic ischaemic heart disease (CIHD) with diffuse coronary sclerosis. Two control groups were compared; those with CIHD who were not operated on, and those who were subjected to pericardocardiopexy. The follow-up periods lasted from 6 months to 10 years. It was established that Weinberg's operation produced good effect in 76% of patients with chronic ischaemic heart disease. The operation is indicated in angina refractory to conservative therapy, with diffuse atherosclerotic lesions of the coronary bed, confirmed angiographically. Concomitant hypertensive disease, obesity, marked cardiosclerosis, recent myocardial infarction decrease the efficacy of Weinberg's operation.

[Mitral restenosis and its surgical treatment]. / Mitral'nyi restenoz i ego khirurgicheskoe lechenie.

The study of late results (from 1 to 16 years) of mitral commissurotomy in 1254 patients showed that restenosis supervened in 11% of cases, and among children and youths below 18 in 19.4%. Immediate results of mitral recommissurotomy were analysed in 747 patients operated on by the "close" method. Complications during the operation were seen in 13.8% of patients, and after operation in 23.1% of cases. The main reasons of lethal outcomes were haemorrhage and cerebral thromboembolism. Low operation mortality and considerable improvement in the majority of cases enable us to consider the "close" operation as the main method to treat mitral restenosis. Calcinosis, gross fibrosis of the valve and marked mitral regurgitation require valve prosthesis.

[Current problems in the surgical treatment of acquired mitral heart defect]. / Sovremennye problemy khirurgicheskogo lecheniia priobretennogo mitral'nogo poroka serdsta.

The experience of 22 years in the surgical management of patients with mitral valvular disease is discussed. A total of 7,122 operations was carried out, among which 6,810 were performed by the closed method and 244 under conditions of extracorporeal circulation. The principal ways for improving the immediate and late postoperative results are discussed.