[Plasma replacement in the treatment of ischemic heart disease]. / Plazmozameshchenie pri lechenii ishemicheskoi bolezni serdtsa.

AIM: To investigate whether plasma replacement (PR) can raise efficiency of drug therapy of ischemic heart disease (IHD). MATERIAL AND METHODS: A 30-60% replacement of circulating plasma for salt or dextran using PF-05 unit has been performed in 324 patients 35-79 years of age with recurrent myocardial infarction and angina pectoris. A total of 520 PR procedures were performed. Biochemical, acid-base, coagulative, viscosity, microcirculatory blood parameters were taken, ECG and stress tests were made. RESULTS: PR resulted in a significant reduction in packed cell volume, total protein, fibrinogen, low density lipoproteins, total cholesterol and led to diminution of blood viscosity, acceleration of capillary blood flow, improvement of O2/CO2. Lowering of fibrinogen levels, number of platelets and their aggregation, enhancement of fibrinolytic blood activity created conditions for moderate controlled hypocoagulation. As shown by stress tests, two weeks after PR 60% of anginal patients of functional class IV can be transferred to class III. CONCLUSION: Because PR is beneficial by many parameters, it lessens the requirement in pharmacological support of patients with complicated IHD.

[Effect of plasmapheresis with substitution by dextran solutions on hemostatic parameters in patients with ischemic heart disease]. / Vliianie plazmafereza s zameshcheniem dekctranovymi rastvorami na pokazatelei gemostaza u bol'nykh ishimicheskoi bolezn'iu serdtsa.

Plasmapheresis on a continuous blood flow fractionator to remove 1,200-2,000 ml plasma and substitute for the same values of dextran solutions was employed in the multi-modality treatment of 25 patients with Functional Classes II-IV exertional angina and myocardial infarction. Plasma and thrombocyte hemostatic parameters were examined just before and 24 and 48 hours after plasmapheresis. The analysis of the baseline data revealed that hemostatic changes were directly related to the severity of a disease in the patients and there was a correlation between the increased platelet aggregability and the elevated levels of fibrin-monomeric complexes. Plasmapheresis along with substitution of removed plasma for dextran solutions was accompanied by a profound hypocoagulative effect, as evidenced by plasma and thrombocyte hemostatic parameters. In addition, in patients with baseline high values of platelet aggregability plasmapheresis resulted in its decrease, whereas in those with baseline low values, it led to its increase.

[Exercise tolerance in patients with exertion angina pectoris after therapeutic plasmapheresis]. / Tolerantnost' k fizicheskoi nagruzke u bol'nykh so stenokardiei napriazheniia posle lechebnogo plazmafereza.

The bicycle ergometric test was used to examine exercise tolerance in 73 patients with coronary heart disease following a single remedial plasmapheresis session, which removed an average of 1562.2 ml plasma. A rapid increase in exercise tolerance was significantly revealed in patients with Functional Class IV exertional angina.

[Intensive transfusion-infusion therapy of patients with cirrhosis of the liver]. / Intensivnaia transfuzionno-infuzionnaia terapiia u bol'nykh tsirrozom pecheni.

Optimum programs have been developed for the differential intensive transfusion-infusion therapy of patients with cirrhosis of the liver, based on the characteristics of the clinical course of the disease and the directed action of varying current solutions. Overtime clinical investigations were conducted in 296 patients with cirrhosis of the liver. The results of the study have shown a favourable effect of the components, blood preparations and hemocorrectors on the clinical signs of the disease, on the function of the liver, kidneys, hemostasis system and microcirculation.

[Plasmapheresis in the treatment of critical stages of ischemia in diabetic angiopathy of the lower extremities]. / Plazmaferez v lechenii kriticheskikh stepenei ishemii pri diabeticheskoi angiopatii nizhnikh konechnostei.

The authors have used gravitation plasmapheresis in the treatment of 26 patients with diabetic angiopathies of lower extremities. It was established that continuous gravitation plasmapheresis facilitated the immediate correction of most of the altered biochemical and coagulation parameters of blood, in patients with diabetes mellitus. The use of rheopolyglucinum is followed by stable central hemodynamics and stabilization of the general state of the patients during continuous plasmapheresis which allows to recommend rheopolyglucinum as the main plasma-substituting solution for fractionation of blood in patients with diabetic angiopathies. The gravitation plasmapheresis used in the treatment of critical degrees of ischemia in patients with diabetic angiopathies of lower extremities is thought by the authors to allow to preserve the extremity or to make the level of its amputation lower in most patients.

[Effectiveness of plasmapheresis on the PF-0.5 blood separator in patients with paraproteinemic hemoblastoses]. / Effektivnost' plazmafereza na fraktsionatore PF-0,5 u bol'nykh paraproteinemicheskimi gemoblastozami.

Plasmapheresis on a Soviet-made PF-0.5 blood cell separator was performed in 20 PPH patients (altogether 33 sessions of plasmapheresis). 1600 to 3300 ml of plasma were removed during one session. Rheopolyglucin was mainly used as plasma-substituting liquid. The procedure was well tolerated by all the patients. After plasmapheresis biochemical indices were within normal. In multiple myeloma paraprotein was decreased by 42%. Waldenström's macroglobulinemia by 47%. Plasma viscosity was decreased 1.2- and 2-fold, respectively. The investigations showed a high efficacy and reliability of plasmapheresis with the help of the Soviet-made PF-0.5.

[Causes of rupture of formalinized xenovalves in the post-transplantation period]. / O prichinakh razryvov formalinizirovannykh ksenoklapanov v posttransplantatsionnom periode

The article discusses results of the morphological study of xenografts of the pig's valves fixed in 0.32% and 4% solution of formaldehyde which remained in the human heart during the period ranging from 21 months to several hours. In the xenovalves there occurred progressive destructive changes in their connective-tissue basis, which led to weakening of the mechanical strength and to rupture of the cusps. In the majority of cases, no morphological signs of immune or nonspecific inflammatory cellular reaction were observed. The authors hold that polycondensation of protein molecules occurring in the course of preservation under the effect of formaldehyde, and formation of "superstrong" structures at the expense of increased number of transversal connections between collagenous fibres not always could ensure sufficient mechanical strength of the cusps of the graft.