[Endovascular treatment of ischemic heart disease in patients with multivessel coronary artery disease: immediate and long-term results].

Immediate and long-term results of endovascular treatment of multivessel coronary artery disease by using different revascularization strategies were analyzed in 171 patients. Duration of follow up ranged from 12 to 18 months. Complete myocardium revascularization was performed in 63 patients, culprit vessel revascularization--in 86 pts and incomplete revascularization--in 22 pts.

[A clinical example of operative intervention on previously stented peripheral artery in a patient with critical ischaemia of lower limbs].

The problem of open surgery of peripheral arteries after previously performed interventions is currently of considerable interest. This is associated with the development of roentgenoendovascular technologies, on the one hand, and with the fact that it is not always possible to use them properly, on the other. Nowadays, one may single out a small group of patients having endured balloon angioplasty and stenting of the arterial segment followed by open operation.

[The long-term results of the endovascular treatment of the ischemic heart disease].

The long-term follow-up treatment results were analyzed for 171 patients operated on the reason of multiple coronary vessels atherosclerosis. The average follow-up time was 14.85 ± 2.

[Short and long-term results of endovascular treatment of bifurcational coronary stenosis].

Short and long-term results of endovascular treatment of true bifurcational coronary stenosis were analyzed in 229 patients. 68 patients received a "provisional-T" stenting on the first stage of the study. On the next stage 40 patients received the same "provisional-T" stenting, a total bifurcational stenting was conducted in 37 patients.

[Surgical manipulations in patients with permanent pacemaker].

Paper is devoted to the safety rules by surgical interventions on patients with permanent pacemaker. Data of 123 operated patients with intraoperative pacemaker instability were analyzed, possible premises of this complications were discussed. The use of monopolar electrocoagulation proved to be the most frequent of reason of pacemaker failure.

[Hermetization of aortic sutures - the comparative analysis of methods].

Leakage of the ascending aortic sutures after the aortic valve replacement with the use of various methods of surgical hemostasis was studied. Results of 244 operations were analyzed. Thus, aortic leakage took place in 50 (20,5%) patients.

[Left ventricular ruptures after the mitral valve replacement].

7 cases of left ventricular rupture after the mitral valve replacement, which occurred per 900 operations performed in our clinic, were analyzed. A successful closure of the defect has been managed in 2 cases. In all cases the external closure with liners and patch plasty was used.

[Diagnosis, treatment and prophylaxis of acute ulcero-erosive gastroduodenal bleedings at cardiosurgical patients].

Results of treatment of 495 patients who has undergone various cardiac operations with artificial circulation are analyzed. The complex program "Blood-free surgery" was used at 388 (78.4%) of them.

[Surgeries on gastrointestinal tract without components of donor's blood].

Results of surgical treatment without transfusion of donor's blood in 58 patients were compared with ones in 40 patients treated with allogenous transfusions. Blood-saving program included preoperative storage of autoplasma, acute normovolemic hemodilution, recombinant human erythropoietin and perftoran. Both groups of patients were similar by types of surgeries performed on gastrointestinal tract.

[Surgery without donor's blood].

Complex program "Surgery without blood" was developed and introduced into a broad clinical practice. The main elements of this program are stimulation of erythropoesis, preparing in autoserum and autoblood before surgery with acute normovolemic hemodilution method, precise surgical technique, reinfusion of blood from wound and drainages, adequate anesthesia and correction of hemostasis system. This program permits one to minimize infusion of donor's blood components (DBC) in elective surgery (cardiosurgery, orthopedic surgery, neurosurgery, oncology, general surgery) and reduce significantly transfusion of DBC in urgent surgery.

[Traumatic surgeries on organs of gastrointestinal tract without components of donor's blood].

The authors propose a complex program aimed to refuse completely using donor's blood components in surgeries on organs of digestive tract. This method was used in 25 patients who underwent surgeries with 380-1500 ml of blood loss. No patients received transfusion of donor's blood components before, during and after surgery.

[One-stage esophagoplasty without transfusion of donor blood components].

Six patients aged from 27 to 62 years were operated for subtotal burn strictures, cancer and glandular polyp of a low-thoracic part of the esophagus using a complex program of non-blood surgery. The following methods were used: collection of autoplasma before surgery by plasmapheresis, collection of autologic packet red cells, normovolemic hemodilution during surgery, use of perftoran for oxygen transport and recombinant human erythropoetin to stimulate erythropoiesis and raise preporative level of hemoglobin. Components of donor blood were not used in these patients.

[The surgical procedural problems in treating mitral restenosis].

The paper summaries the experience with 244 operations for mitral restenosis. The methods for surgical treatment of mitral restenosis: closed mitral recommissurotomy, valvuloplasty, and mitral valve prosthesis are comparatively analyzed. Indications and contraindications are defined for relapse.

[Evaluation of right ventricular myocardial excursions in patients with mitral valve stenosis without pulmonary hypertension].

As many as 23 patients with mitral stenosis were examined intraoperatively, by evaluating of intracardiac hemodynamics and right ventricle myocardial excursions. Before mitral stenosis was corrected, 56% of patients had demonstrated myocardial excursion disorders. After the correction the number of patients with myocardial dysfunction halved.

[Clinical and functional correlations of left-atrial myocardial excursions in patients with mitral valve defects (I)].

Three types of atrial excursions correlating with the somatic symptoms of circulatory and respiratory dysfunctions, as well as with the degree of left atrial dilatation were intraoperatively recorded in patients with mitral valvular disease. Types I and II excursions were more common in patients with left atrioventricular stenosis, Type III in those with mitral incompetence. It is concluded that it is advisable to use left atrial myocardial excursion characteristics in the diagnosis of cardiac disease.

[Rupture of the posterior wall of the left ventricle after mitral valve prosthesis].

Rupture of the posterior wall of the left ventricle after mitral valve prosthetics is a rare (0.6%) but a dangerous and death-threatening complication. Injury to the fibrous ring in the anatomically hazardous zone (at 4-5 o'clock of an imaginary clock-face) is the most frequent cause of the ruptures.