[New system for diagnosing acute circulatory disorders and assessing drug choice and dosage].

The assessment of the status of a patient and diagnosis are first made strictly algorithmically. At the same time the procedure is monitored by a physician in terms of his experience and knowledge. The dialogue is made on the basis of a model and images which reflect the pattern of blood circulation.

[Active valvular infective endocarditis: problems of surgical treatment].

The authors analyze the results of surgical treatment of patients suffering from active endocarditis with impairment of the mitral, aortal and tricuspid valves and their combinations in 242 patients operated on during 1969 to 1989. The total hospital mortality is at the level of world statistics and constitutes 15.3% (37 patients died).

[Experience with a prosthesis of the pulmonary artery trunk at the A.N. Bakulev Institute of Cardiovascular Surgery, Academy of Medical Sciences, USSR].

From April 1975 to March 1991 sixty-four operations were carried out on 61 patients with various congenital heart diseases attended by impaired anatomical connection between the right ventricle and the pulmonary arteries. The patients' ages ranged from 9 months to 28 years (8 years on average). The most frequent clinical diagnoses were total transposition of the great vessels with ventricular septal defect and stenosis of the pulmonary artery (26 cases), type I common arterial trunk (14), Fallot's tetralogy (11 cases).

[The necessity for a differentiated approach to the treatment of acute disorders of the coronary circulation].

The article discusses problems of the tactics of treatment of acute disorders of coronary circulation with the use of radiologically-guided intravascular and surgical methods along with drug therapy. The authors conclude on the basis of accumulated experience that in most patients, both in unstable angina pectoris and in acute myocardial infarction, there is no need for emergency procedures and operations for direct revascularization of the myocardium, which should be resorted to only in patients with complete irresponsiveness to drug therapy. After stabilization of the condition, however, the tactics of diagnostic and therapeutic measures must be differentiated according to the patients' clinical condition and a series of laboratory indices.

[An automated management system for a polyclinic].

The authors review the main problems occurring in introduction of computer-aided technology of data collection, processing and storage at the polyclinics, scientific-counselling departments of the medical institutes and centers, taking into account the level of the development of Soviet computers and documentation science. The developing engineers and medical personnel are rather far from being fully aware of the whole complex of the problems they confront. This results in low efficacy of the use of the elaborated automated systems, giving rise to factors interfering with successful operation of the systems.

[Origin of the aorta and pulmonary artery from the right ventricle].

In the period of 1980 to February 1988, 60 patients aged 1 year 7 months to 23.5 years were operated on for concordant atrioventricular linkage and origin of the aorta and pulmonary artery from the right ventricle. Sixty-two heart specimens were examined to study the defect anatomy.

[Pulmonary hypertension in surgery of ventricular septal defects].

The article discusses the appraisal of the degree of pulmonary hypertension and surgery of a ventricular septal defect with pulmonary hypertension in 108 patients whose ages ranged from 8 months to 31 years. The hemodynamic and morphological manifestations of pulmonary hypertension were found to increase with age. The hemodynamic manifestations of the anomaly may be similar in different types of changes of the vascular wall.

[Correction of anomalous origin of the left coronary artery from the pulmonary trunk].

The article describes a successful operation for hemodynamic correction of anomalous origin of the left coronary artery from the pulmonary trunk which was carried out for the first time in the Soviet Union. Experience in such operations according to the data in world literature is analysed. The authors point out the peculiarities of recognizing anomalous origin of the left coronary artery from the pulmonary trunk in "asymptomatic" patients with no classical manifestations of the anomaly.

[Acute disorders of the blood circulation and cardiac insufficiency following open heart surgery].

General theoretical aspects (classification of circulatory disorders and heart failure) and results of research into specific subdivisions of cardiovascular and respiratory system pathology in cardiac surgical patients are discussed. The material is aggregated by the applied clinico-mathematical approach that has been developed and introduced into clinical practice in the recent 15 years at the Bakulev Institute of Cardiovascular Surgery. The extension of the clinico-mathematical approach onto the intraoperative control and analysis of the patients' status, assessment of the anaesthetic administration and cardioplegic protection is first overviewed.

[Experience with the creation of microcomputer-based automated case history system].

The article sums up the experience in using an automated case history handling system at the Bakulev Institute of Cardiovascular Surgery for improving treatment and raising research efficiency. The system is designed for collecting, storing, processing and giving out information about the results of diagnosis and treatment of patients in the form convenient for the physician. It is based on the dialogue principle in respect of setting, searching and processing medical data and on the principle of independent work of the personnel with the system terminals installed in different clinical departments.