[The immunomodulating properties of vitamin E in surgery involving artificial circulation]. / Immunomoduliruiushchie svoistva vitamina E pri operatsiiakh s iskusstvennym krovoobrashcheniem.

The immunomodulating effect of vitamin E was studied in 21 patients who underwent operation on an open heart. The vitamin was administered in a dose of 40 mg/kg 3.5 hours before the operation for anti-ischemic protection in cardiosurgical operations with extracorporeal circulation. The immune status was evaluated according to the level of phagocytosis, the index of leukocyte migration, the total leukocyte count, the number of immune complexes, and the immunoglobulin level. An immunodepressive effect of extracorporeal circulation was noted. The postoperative phagocytosis values were higher (p less than 0.05) in patients given vitamin E. The postoperative leukocytosis level was lower (p less than 0.01) than in the control group and the leukocyte response to mitogen remained adequate, in contrast to that in the control group. No statistically significant differences in the level of immune complexes and immunoglobulins were obtained. It is concluded that the degree of immunodepression in the postoperative period decreases in patients given vitamin E in the indicated dose before the operation.

[Development of clinical physiology in heart surgery]. / Razvitie klinicheskoi fiziologii v kardiokhirurgii.

The article deals with the analysis of the monograph Evaluation of Performance and Analysis of Cyclic Work of the Heart written by B. A. Konstantinov, V. A. Sandrikov, and V. F. Yakovlev. It discusses the possible mechanism of the maintenance of the stability of hemodynamic indices--switching into action the contractions of nonfunctioning cardiomyocytes (the factor of functional heterogeneity).

[Ion-balanced cardioplegic solutions in cardiac surgery]. / Ionosbalansovannye kardioplegicheskie rastvory v khirurgii serdtsa.

A comparative analysis of effectiveness of anti-ischemic defense of the myocardium performed in operations on the heart in 128 patients has shown that use of ion-balanced solutions is preferential since it allows reducing intrahospital lethality related with acute cardiac insufficiency from 13.3% to 6.3%.

[Potentiation of the anti-ischemic effect of cardioplegic solutions by phosphorylated metabolites]. / Usilenie protivoishemicheskogo deistviia kardioplegicheskikh rastvorov fosforilirovannymi metabolitami.

An experimental study in 307 isolated rat hearts was concerned with variations in myocardial resting tension, resting membrane potential, ATP levels and myocardial heat production in conditions of cardioplegic heart arrest by an ion-balanced cardioplegic solution with and without phosphorylated metabolites (ATP, phosphocreatine, inosine-F, glucose-6-phosphate) and dephosphorylated metabolites (glucose, inosine, and inorganic phosphates). Phosphorylated metabolites, incorporated in the solution, had a marked protective effect due to the activation of substrate regulation mechanisms at different stages of ATP synthesis and facilitation of cardiomyocyte adaptation to ischemic, hypothermic and cardioplegic exposure.

[Effect of perfluorocarbon emulsions on the protective properties of cardioplegic solutions]. / Vliianie émul'sii perftoruglerodov na zashchitnye svoistva kardioplegicheskikh rastvorov.

The influence of ischemia and conventional and emulsion cardioplegia on the dynamics of resting tension, Ca2+ concentration, the level of membrane potential and oxygen tension in the myocardium was studied. It was shown that emulsion cardioplegia prolonged the duration of anoxic protection due to the additional oxygen supply of tissues and the decrease in Ca2+ cytoplasm accumulation.

[Action of vitamin E on the normal myocardial energy balance and in ischemia and reoxygenation]. / Deistvie vitamina E na énergobalans miokarda v norme, pri ishemii i reoksigenatsii.

The energy mechanisms of formation of anti-ischemic myocardial resistance have been studied by means of vitamin E, administered to rats 24 hours before modelling ischemia in a dose of 200 mg/kg, in which the antioxidant activity of the preparation is pronounced. At the stage of ischemia, myocardial energy was studied by the differential calorimetry method, in the pre- and postischemic periods on a functioning heart in a stand according to Neely. It is shown, that vitamin E in ischemic and postischemic periods enhances the power and efficiency of myocardial energy consumptions: decreases irrational energy consumptions in the initial period of ischemia (the first 15 minutes) and supports a higher level of energy production further on, increasing thus the admissible periods of myocardial ischemia from 20-25 to 30-35 minutes, maintains in the postischemic period a higher level of total useful energy consumptions and coefficients of the oxygen utilization efficiency as compared with the experiments without preliminary administration of vitamin E. It is shown, that the anti-ischemic defence of the myocardium by vitamin E is formed already in the preischemic period and conditioned by redistribution of energy consumptions and growth of the share of energy consumptions aimed at the maintenance of the initial structural-functional homeostasis of myocardial cells.

[Use of balloon catheters for intraoperative control of resting myocardial pressure during cardioplegia]. / Ispol'zovanie kateterov s ballonchikom dlia intraoperatsionnogo kontrolia za nadpriazheniem pokoia miokarda pri kardioplegii.

Twenty-two patients operated on for aortal, mitral and multivalvular prosthesis under pharmacological cardioplegia were examined for the purpose of monitoring myocardial resting tension by the tensometric method and by using modified balloon catheters. The results demonstrated that the use of the balloon catheters permits making not only qualitative and quantitative assessments of myocardial lesions and a prompt evaluation of the function of the arrested heart but also the initial myocardial contractility and the restoration of myocardial contractility after cardioplegic arrest by controlling the contraction and relaxation myocardial rate.

[Ways of increasing the protective effect of cardioplegic solutions]. / Puti usileniia zashchitnogo deistviia kardioplegicheskikh rastvorov.

An experimental study on rat hearts using continuous recording of myocardial tension showed that the addition of various groups of drugs to the solution had negative effects on heart function. Positive effect was achieved when cardioplegia was combined with the pretreatment of animals with anti-ischemic drugs (alpha-tocopherol, dimethylsulfoxide) as well as preliminary oxygenation of the medium. Possible mechanisms of these myocardial effects are discussed.

[Mechanisms of myocardial protection and damage under the effects of cardioplegic solutions]. / Mekhanizmy zashchity i povrezhdeniia miokarda pri deistvii kardioplegicheskikh rastvorov.

An experimental study on rat hearts has demonstrated that cardioplegic solutions, apart from their protective effect, activate energy-consuming calcium redistribution process. Presented data permit qualitative and quantitative assessment of myocardial changes and a prompt evaluation of arrested heart's functional status.

[Intraoperative control of the state of the arrested heart]. / Intraoperatsionnyi kontrol' za sostoianiem ostanovlennogo serdtsa.

Monitoring the function of the operated on heart over time based on the principle of recording the effort of the myocardium at rest was tried under the clinical conditions after preliminary experiments on the hearts of rats and dogs. The study included 11 patients operated on for aortal, mitral and multi-valvular prosthetics under pharmacological cardioplegia. Such monitoring enables an objective appraisal of the heart status, Besides, it makes it possible to decide on whether repeated administration of cardioplegic solutions is required, to specify the times of reoxygenation and to prognose the pattern of the heart function recovery after operation is over. The data obtained helped detect some disadvantages of the generally accepted method of pharmacological cardioplegia.

[Preservation of an isolated kidney in normothermic conditions by perfluorotributylamine emulsion perfusion]. / Sokhranenie izolirovannoi pochki v normotermicheskikh usloviiakh s pomosch'iu perfuzii émul'siei ftortributilamina.

Perfluorotributylamine emulsion (PFE) was used to preserve an isolated dog kidney under normothermal conditions with the aid of perfusion. The latter was carried out for 4 hours with the use of a pulse pump. The protein-saline solution (PSS) - 5% donor's albumin in Hanks solution, was used for reference purposes. During PFE perfusion, oxygen consumption by the kidney was noticed to be increased at the expense of a rise in the arterio-venous difference. Glucose concentration in the perfusate was unchanged during PFE perfusion, while that in PSS declined. Lactate dehydrogenase activity in PFE was noticeably lower than in PSS. During PFE perfusion, the concentration capacity of the kidney was 3.5 times higher as regards creatinine and 7.5 higher as regards potassium. It has been demonstrated that the 4-hour normothermal renal perfusion with 20 v% PFE enables preservation of the renal function.