THE AORTAL VALVE PROSTHESIS, USING MINIMALLY INVASIVE ACCESS.

The investigation objective was to improve the immediate results of surgical treatment of the aortal valve failure, applying minimization of operative trauma and, accordingly, rapid functional rehabilitation of patients. The aortal valve prosthesis, using minimally invasive access, was conducted in 44 patients. There was proved, that conduction of ministernotomy for strict indications is effective and have significant advantages, com' paring with classic median sternotomy, because it provides minimal surgical trauma, preservation of the thoracic cage frame, and better cosmetic effect.

[Oxygen metabolism with low hematocrit levels in the course of guided hemodilution procedure in cardiosurgical patients]. / Obmen kisloroda v usloviiakh nizkogo gematokrita pri provedenii upravliaemoi gemodiliutsii u bol'nykh kardiokhirurgicheskogo profilia.

Influence of hemodilution on the oxygen metabolism in patients, operated, using the artificial blood circulation apparatus, was studied up. Factors, determining the oxygen delivery to tissues, was estimated, correlational links between the blood rheological properties and its oxygen--transporting function were established. Experience of application of apparatus Aeprex, promoting the oxygen delivery to tissue improvement and the need in donor's blood lowering, performing operations, using the artificial blood circulation apparatus.

[The evaluation of application efficacy of cardioplegic solution with perftoran in addition to surgical correction of congenital heart defects]. / Otsenka éffektivnosti primeneniia kardioplegicheskogo rastvora s dobavleniem perftorana pri khirurgicheskoi korrektsii porokov serdtsa.

Experience of the myocardium defense for correction of the heart failures in conditions of artificial blood circulation was analyzed in 55 patients. Antegrade pharmacool crystalloid cardioplegia, based on the potassium chloride solution was applied in 32 patients. In 23 patients perftoran was added to cardioplegic solution. Investigations of systemic hemodynamics in early postperfusion period data of electrocardiography and of the biopsies histological investigation as well confirm the efficacy of cardioplegic action of crystalloid cardioplegic solution raising while its oxygenation, after adding perftoran in its contents.

[Hospital infection and rational antibacterial therapy in conduction of operative interventions in cardiac surgery]. / Gospital'naia infektsiia i ratsional'naia antibakterial'naia terapiia pri vypolnenii operativnykh vmeshatel'stv v kardiokhirurgii.

The results of bacteriological monitoring in intensive care units of ICVS AMS of Ukraine, specializing on the treatment of patients after conduction of operation on "open heart", were analyzed. In 1998-2001 yrs the S. Epidermidis and Enterobacter strains had constituted the most frequent causes of septic state in patients. Experience of application of different antibacterial preparations was summarized, the main principles of their administration were formulated. Modern approaches to the treatment and prophylaxis of purulent-septic complications were depicted.

[Methods of myocardium defense in radical correction of Ebstein anomaly]. / Metody zashchity miokarda pri radikal'noi korrektsii anomalii Ebshteina.

Experience of myocardium defence while correcting Ebstein anomaly in 75 patients was analyzed. In 25 patients antegrade pharmacorefrigerating crystalloid cardioplegia based on potassium chloride was applied, in 10--method of Kirsch using miganesiun-aspartate-procaine solution. In 40 patients antegrade pumping of normothermic potassium chloride solution with subsequent antegrade infusion of cooled magnesium-aspartate-procaine solution applied for primary heart arrest. Application of combined defence of myocardium using normothermal crystalloid cardioplegia and refrigerating, of antegrade infusion of magnesium-asparate-procaine cardioplegic solution has advantages in comparison with another methods of myocardium defence, reduces the threat of an acute cardiac insufficiency occurrence in early postoperative period.

[Early extubation of children in the the first year of life with inborn heart failure after surgery, performed with artificial blood circulation]. / Ranniaia ékstubatsiia detei pervogo goda zhizni s vrozhdennymi porokami serdtsa posle operatsii s primeneniem iskusstvennogo krovoobrashcheniia.

The possibility of early extubation of the first year of life children after surgical correction of congenital heart diseases while artificial blood circulation conduction was studied. For the 1996-1999 period surgical treatment was conducted in 381 patients aged at average (5.71 +/- 3.17) month, body mass at average (5.77 +/- 1.8) kg. 163 (42.7%) patients were converted to independent respiration in 6-12 hours after operation, satisfactory clinical state and indexes of gas exchange were in 122 (74.8%), 8 patients needed reintubation. Early extubation permit to reduce of respiratory complications frequency, duration of treatment in intensive therapy unit.