[Surgical treatment of primary tumors of the heart]. / Khirurgicheskoe lechenie pervichnykh opukholei serdtsa.

The article discusses the experience in surgical treatment of tumors of the heart in 34 patients in clinics of cardiosurgery at the Riga Medical Institute and the Institute of Cardiology and Cardiovascular Surgery of Havana (Cuba). Twenty-five patients underwent operations for benign tumors of the heart (16 myxomas, 2 leiomyomas, 2 fibromas, 1 lipoma, 1 angiofibroma, 2 coelomic cysts) under extracorporeal circulation, with 4% lethality. No recurrences were encountered in follow-up periods of 5 months to 14 years. Nine patients had malignant tumors; the tumor was removed successfully in 3 of them, even with resection and prosthetic replacement of the outflow tract of the right ventricle. Only 3 of the patients (33%) who were operated on had a follow-up period of more than 1 year.

[Diagnosis and treatment of the respiratory distress syndrome during surgery in children under artificial circulation]. / Diagnostika i lechenie respiratornogo distress-sindroma pri operatsiiakh u detei v usloviiakh iskusstvennogo krovoobrashcheniia.

The authors examined 152 children with congenital heart diseases complicated by pulmonary hypertension. 109 patients were operated on under conditions of hypothermic perfusion and 43--under deep hypothermia with extracorporeal circulation. Combination of disturbed mechanics of respiration and gas exchange was determined as the respiratory distress syndrome. The initial value of lung expansibility was found to be in inverse proportion to the degree of pulmonary hypertension. With the increase of pulmonary hypertension lung expansibility reduced before extracorporeal circulation and gas exchange became worse. Hypothermic perfusion at volumetric rates of 1.7-2.55 l/min/m2 led to diminished lung expansibility in the early postperfusion period of the operation, the mechanics and gas exchange grew worse. In patients who underwent operation under conditions of deep hypothermia the values of lung expansibility and gas exchange were stable. The incidence of the respiratory distress syndrome was 56.3% after hypothermic perfusion and 7.2% after deep hypothermia.

[Possibilities of using implanted elastic magnetic elements in reconstructive operations on the abdominal aorta and its branches]. / Vozmozhnosti ispol'zovaniia implantiruemykh élastichnykh élementov pri rekonstruktivnykn operatsiiakn na briushnoi aorte i ee vetvakn.

A new method based on the use of elastic magnetic elements has been developed for reconstructive surgery on the abdominal aorta and its branches. In 135 experimental operations and subsequent clinical trial of 40 operations, an oriented 5 and 10 mT elastic magnetic element was implanted to the centre of the reconstruction site, resulting in a considerable reduction of the rate of thrombosis in the reconstructed arterial segments.

[Arrhythmia associated with continuous cardiac pacing]. / Narusheniia ritma pri postoiannoi élektrokardiostimuliatsii.

The incidence and diagnostic criteria of heart rhythm disorders associated with a permanent pacemaker were assessed on the basis of data, obtained at a single electrocardiography in 1165 patients and continuous ECG recording in 49 patients. A high (94.4%) incidence of the spontaneous and induced rhythm competition at asynchronous stimulation has been demonstrated, indicating that the use of this stimulation regimen should be abandoned. The inhibition of a unipolar pacemaker by myopotentials at regular physical activity is rather uncommon and has no clinical value. VVI stimulation is often (45.2%) associated with variants of escape-capture bigeminy.

[Histochemical and ultrastructural evaluation of myocardial protection during correction of congenital heart defects with cardioplegia]. / Gistokhimicheskaia i ul'trastrukturnaia otsenka zashchity miokarda pri korrektsii vrozhdennykh porokov serdtsa v usloviiakh kardioplegii.

A combined stepwise light- and electron-microscopic examination of myocardial incision biopsies was carried out in 129 children with congenital valvular defects that were corrected under hypothermal extracorporeal circulation making use of cold or combined drug cardioplegia. Changes in the myocardium were suggestive of its original weakness. Structural changes were small-focal and reversible. Drug cardioplegia allowed to switch off the heart for longer periods (115 min) of time, yet the maintenance of a stable temperature regimen should be regarded as the key factor of successful cardioplegia.

[Clinical aspects, diagnosis and surgical correction of congenital aortopulmonary septal defect]. / Klinika, diagnostika i khirurgicheskaia korrektsiia vrozhdennogo defekta aortolegochnoi peregorodki.

Characteristic signs of a rare abnormality of the major vessels, an aortopulmonary septum defect, are described. This pathology is associated with shunting and discharge of blood from the left to the right and an early development of pulmonary hypertension. The clinical course of the defect depends on the degree of the hemodynamic impairment in the pulmonary circulation. It has been elucidated that aortography with catheterization and contrast examination of the right portions of the heart is the method of choice in the diagnosis of this defect. Surgical correction of the defect is the only radical method of treatment. The long-term results of surgical treatment are promising.

[Surgical treatment of suppurative anterior mediastinitis after open heart surgery for congenital defects]. / Khirurgicheskoe lechenie perednego gnoinogo mediastinita posle operatsii na otkrytom serdtse po povodu vrozhdennykh porokov.

After 466 operations performed by the transsternal access under conditions of artificial blood circulation for congenital heart diseases anterior purulent mediastinitis developed in 78 patients (16,73%). Different methods of treatment were used: open wound method, repeated mediastinotomy, drainage of the retrosternal space and a method of flowing-fractional washing. Postoperative lethality was reduced (to 0) and duration of treatment was shortened (from 80 to 24,5 days).