[Clinical aspects, diagnosis and surgical treatment of rupture of the mitral valve chordae].

The authors generalize experience in surgical treatment of 121 patients with mitral incompetence caused by rupture of the chordal threads. Prosthetics of the mitral valve was conducted in 103 patients, plastic correction--in 18 patients. Study of the etiomorphological aspects of the problem showed destruction of the fibrous framework of the chorda to be a compulsory component of rupture of the chordae of various origin.

[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).

[Morphogenesis of apico-aortic conduit implantation (data of an experimental study].

The article discusses the results of complex morphological research concerned with study of the histological structure of an extracardiac conduit in late-term periods after its implantation into the left ventricular-aortic position. The authors conducted a qualitative analysis of the morphogenesis of implantation of a conduit--an original new outlet tract from the left ventricle of the heart. The rich experimental material confirms the conclusion that the new outlet tract from the left ventricle of the heart is marked by complete functional competence adequate for conditions of systemic circulation.

[Clinico-morphological comparison in children with infectious endocarditis].

As many as 21 children suffering from infectious endocarditis (IE) were examined for the clinical and morphological picture of the disease. The patients' age ranged from 2 to 15 years. In 15 children, IE developed in association with different congenital diseases; in one patient, in the presence of rheumatic heart disease, and in 5 patients, in unaffected heart valves.

[Surgical treatment of endocarditis following heart valve prosthesis].

Experience of many years in surgical treatment of prosthetic valve endocarditis (RVE) is analyzed. Patients whose condition was serious were operated on for a second time: 91.6% had preoperative functional class IV, in half of them circulatory disorders were of stage IIB--III; 62.

[Possibilities of cardiac surgery in the treatment of active valvular infectious endocarditis].

The results of surgical treatment of 142 patients with active valvular infectious endocarditis are reviewed. Hospital mortality was 15.5% (22 patients died).

[Morphology of heterologous aortic bioprostheses intended for clinical use].

Results of an experiment on the preservation of bioprostheses prepared from porcine aortal valves are presented. It is described how the structure of the cusps is affected by autolytic processes, by exposure to various concentrations of glutaraldehyde, and by sequential exposure to glutaraldehyde and papain solutions. Xenogeneic aortal complexes must be processed within the first 24 hours after collection since later on they undergo autolysis whereby the fibroblasts are destroyed and collagen fibrils become damaged.

[Morphology of infectious endocarditis affecting bioprostheses of the cardiac valves].

Four varieties of infectious endocarditis were identified after cardiac valve bioprostheses: early acute, early subacute, late acute, and late subacute forms. Any of these forms may be of bacterial, fungal, or mixed (bacterial and fungal) origin. In the early forms, the infection was of exogenous origin, with a predominance of Gram-positive organisms, whereas in the late forms it was endogenous with a preponderance of Gram-negative flora.

[Mechanisms of mineralization of aortic xenograft bioprostheses in young patients].

The results of mitral valve replacement with aortic xenobioprostheses in 15 patients, aged 14 to 20 years, are presented, the follow-up reaching 7 years. The bioprostheses functioned normally 1.5-2 months after the operation.

[Remote results of the correction of mitral valve defects with aortic xenobioprosthesis].

An analysis of the 6-year observations of 84 patients with aortal xenobioprosthesis in the mitral position has shown the bioprostheses to give an adequate and stable correction of hemodynamics, low risk of thromboembolic complications. The anticoagulation therapy was found to be not necessary in most of the patients. The aortal xenobioprostheses in patients older than 20 gave high survival rate (93%) and low risk of specific complications (5,4%).

[Morphology of transplanted valves in patients with acquired heart defects].

The investigation was based on the examinations of 85 aortal valves of man and swine after conservation in 1% betapropiolactone solution, 4% formaldehyde solution, 0.6% glutaraldehyde solution and after treatment with gamma-rays preceded by freezing. Besides, 38 allo- and xenotransplants of valves preserved by the above methods which had functioned in the mitral and tricuspidal positions in patients for 1 day to 9 years were examined.