[Superior vena cava blood flow measurements for results prognosing of a bidirectional cava-pulmonary anastomosis in correction of hemodynamics parameters in patients with hypoplastic right ventricle].

The method of prediction the enability of closure atrial septal defect before operation or in pre-bypass period during the one and one-half ventricle repair of CHD with hypoplastic right ventricle was presented. The method is based on comparison of the initial blood flow on superior vena cava (SVC) and right-to-left shunt at atrial level. Defect can be closed if flow on SVC and shunt flow are approximately equal. According to prognosis in 16 of 37 patients defect was closed. After operation there were not signes congestive heart insufficiensy and cyanosis. This approach allowes to avoid reoperations at least in half of patients. If shunt flow exceeds flow on SVC, defect must be left open.

[Treatment of patients with three-atrium heart].

Typical three-atrium heart constitute a rare inborn heart failure, in which pulmonary veins drain into the proximal additional camera of the left atrium, separated from distal left pericardium cavity of it own by diaphragm, in which there is one or more restrictive apertures. Of 6770 patients, consecutively operated on by one surgeon, in 15 (0.21%) ageing from 7 mo to 30 years the three-atrium heart was revealed. In all the patients the surgical correction of the failure was accomplished using artificial blood circulation. The early diagnosis and surgical treatment of the patients, suffering three-atrium heart failure, secures good late results and quality of life.

[Complete cava-pulmonary conjunction in surgical treatment of heart abnormalities with a single functionally active ventricle]. / Primenenie polnogo kavapul'monal'nogo soedoneniia v khirurgicheskov lechenii anomalii serdtsa s funktsional'no edinstvennym sheludochkom.

Complete cavapulmonary conjunction (CCPC) was done in 27 patients, in 3 of whom the tricuspid valve atresia and in 24--various forms of the heart only ventricle. In the early postoperative period 7 (25.9%) patients died. Application of the modified CCPC forming an unloading aperture in the intraatrial channel wall had promoted the surgical treatment results improvement.

[The use of bi-directional cava-pulmonary anastomosis in the treatment of severe congenital heart defects]. / Primenenie dvukhnapravlennogo kava-pul'monal'nogo anastomoza v lechenii slozhnykh vrozhdennykh porokov serdtsa.

Two-directional cava-pulmonary anastomosis was done in 35 patients with a inborn heart failure, ageing from 10 months to 11 years. In 29 patients the significant improvement of their state was noted. The level of arterial blood saturation with an oxygen have rised up to (90.1 +/- 2)% at average. Of 7 patients with the syndrome of right ventriculus hypoplasia one have died, of 27 patients with the single venticular heart-3.

[Comparative study of the results of prosthesis implantation and reconstructive surgery of the mitral valve in congenital insufficiency]. / Sravnitel'naia otsenka rezul'tatov protezirovaniia i plasticheskoi rekonstruktsii mitral'nogo klapana pri ego vrozhdennoi nedostatochnosti.

In 23 of 154 patients with congenital mitral valve (MV) insufficiency the MV prosthetics was conducted, and in 23-valve-preserving reconstructive operation. Operative procedures were depicted, early and late follow-up results were analyzed. After the valve-preserving operation conduction hospital lethality was 8.7%, and after the (MV) prosthetics-34.8%. In the late follow-up period after (MV) plastic reconstruction conduction good results were noted in 17 patients, satisfactory-in 1, reoperation was performed in 3 (13%). Application of soft synthetic ring, preventing the dilation of the valve fibrotic ring, may to lower the frequency of reoperation conduction. Plastic correction of the CMVI permits to eliminate the basic haemodynamical disorders and to avoid or postpone the MV prosthetics conduction, what especially important in children.

[The factors influencing the incidence of heart rhythm disorders after the radical correction of the tetralogy of Fallot]. / Faktory, vliiaiushchie na chastotu narushenii ritma serdtsa posle radikal'noi korrektsii tetrady Fallo.

The frequency and factors favouring the development of cardiac rhythm disorders were studied in 306 patients operated on radically for Fallot's tetralogy (follow-up: 6 months--29 years). This complication was found in 99 patients (32.3%). Most patients showed ventricular arrhythmia--62 (62.6%). Paroxysmal tachycardia was noted in 11 patients, atrio-ventricular block in 15 patients, combination of different arrhythmias in 11 patients. Risk factors were: inadequate correction of the malformation, age over 15 at the time of operation, approach through the right ventricle with plastic repair of the drainage tract, five years after surgery.

[Residual shunts following the correction of interatrial defects]. / Ostatochnye shunty posle korrektsii mezhpredserdnykh defektov.

The mechanisms and causes of the development of residual shunts after closure of atrial septal defects were studied on the basis of the analysis of the results of 17 reoperations for this complication. It was established that errors of surgical correction were the most frequent causes of residual shunts: an attempt to close large defects with sutures, use of a graft smaller than the size of the defect, concomitant anomalies which caused the reshunting, and incomplete correction of the defect.

[Morphogenetic patterns of isolated infundibular stenosis of the pulmonary artery]. / Nekotorye morfogeneticheskie zakonomernosti izolirovannogo infundibulirnogo stenoza legochnoi arterii.

It was found that in isolated infundibular stenosis of the pulmonary artery a mass of muscle-fibrous tissue creates an obstacle to blood flow in the right ventricle. Morphogenetic regularities of compensatory and adaptive reactions in isolated infundibular stenosis are similar to those observed in hypertrophic cardiomyopathy. It may be suggested that abnormalities in the structure of the hypertrophied myocardium in isolated stenosis of the right ventricle infundibulum is a result of a fundamental error in the cardiac morphogenesis and not a reflection of increase of the degree of cardiac hypertrophy.