[PECULIARITIES OF ROTATIONAL MOTION OF LEFT VENTRICULAR WALLS IN PATIENTS ON MITRAL VALVE INSUFFICIENCY].

The peculiarities of rotational motion of left ventricular (LV) walls in patients on mitral valve insufficiency (MVI) were studied. In normal heart and MVI the rotation of basal and apical portions of the LV occurs in inter-reverse directions: the basal portion rotates clockwise and apical portion rotates counterclockwise. In patients with MVI the increase of the LV volumes is accompanied by compensatory rise of LV myocardium torsion up to (23.

[Dilated cardiomyopathy: the role of left branch of atrioventricular bundle block in left ventricular walls longitudinal strain indices change].

Activity of the heart is assured by the myocardium motion with a composite path, which can be described with various quantitative indices, in particular the strain ones. The invention and implementation into clinical practice the "Speckle Tracking" ultrasonic technology, based on the two-dimensional echocardiography, allows to study of normal myocardium function as well as its functioning in various hart lesions, in particular, dilated cardiomyopathy (DCMP). Peculiarities of the features of longitudinal strain parameters of left ventricular (LV) walls in patients with DCMP, according to the occurrence of the total left branch of atrioventricular bundle block were studied.

[Longitudinal shift of left ventricle walls in norm and in dilated cardiomyopathy].

Peculiarities of longitudinal shift of the left ventricle (LV) walls were studied in patients in various variants of dilated cardiomyopathy (DCMP). In patients, suffering DCMP, the enhancement of the end-diastolic (EDI) and the end-systolic (ESI) indexes are noted, as well as of the punch index and expulsion fraction, the pulmonary artery hypertension, moderate insufficiency of mitral and tricuspid valves. These changes are aggravated in complete blockade of left pedicle of atrio-ventricular fascicle (AVF).

[Atherosclerosis of ascending aorta as a risk factor for neurological complications occurrence in surgical treatment of the ischemic heart disease].

Own experience of the ischemic heart disease (IHD) surgical treatment, combined with the ascending aorta (AA) atherosclerosis, was analyzed. Basing on results of surgical treatment for IHD there were noted mostly informative methods of diagnosis of the AA atherosclerotic affection severity and optimal approaches to surgical treatment of such patients.

Is surgery the gold standard in the treatment of obstructive hypertrophic cardiomyopathy?

Objectives: Hypertrophic cardiomyopathy is a complex and relatively common genetic cardiac disease and has been the subject of intensive scrutiny and investigation for over 40 years. The aim of this non-randomized cohort study was to compare subjective and objective outcomes in hypertrophic cardiomyopathy patients undergoing drug therapy, surgical myotomy-myectomy, dual-chamber pacing and alcohol septal ablation.

Methods: We examined 194 patients: 103 with non-obstructive hypertrophic cardiomyopathy and 91 with obstructive hypertrophic cardiomyopathy.

[Significance of immunological investigations in the studying of various forms of cardiomyopathy].

The data concerning the role of the immune and inflammatory reactions activation in formation of dilatational and hypertrophic cardiomyopathy were presented. The dependence of the humoral-inflammatory disbalance progressing on the processes of the apoptosis and inflammatory cytokins level regulation, determining the immune answer disorder degree in relation with cardiomyopathy form, was established.

[Integral mechanisms of regulation of oxygen delivery and consumption in human body].

With new algorithms of pattern recognition three types of regulation of oxygen delivery and consumption were studied: at normal regulation, hypo- and hyperfunction of heart. It is shown that a surplus systemic blood flow results in increase of arterio-venous shunt flow. Insufficient blood flow results in increase of arterio-venous gradient of blood oxygen content due to the increase of gradient of oxygen content on both sides of capillary wall and to activating of vasomotor function of microcirculatory arterial bed.

[Surgical treatment of the aortic arch aneurysm. Immediate results].

There was performed the retrospective analysis of 23 consecutive patients, to whom beside the ascending aorta aneurysm correction the aorta arch prosthesis was done in conditions of deep hypothermia, the blood circulation arrest with retrograde cerebral perfusion via vena cava superior. For an acute layering and aneurysm of aorta with pericardium tamponade or hemothorax occurrence 16 (69.6%) of patients were operated on in emergency.

[Diagnosis and treatment of biatrial myxomas of the heart].

Of the multiple myxomas of the heart (MH) the bilateral myxomas were revealed in 57.1%. Of 4 patients before the operation the correct diagnosis was established only in one.

[Changes in immune status in patients with infectious endocarditis in surgical treatment involving artificial blood circulation].

In 98.2% patients with infectious endocarditis, admitted to the hospital for surgical treatment, the moderate immune deficiency state is revealed with the cell link of immunity depression and phagocytic function of neutrophils insufficiency, which become aggravated after operative intervention performance, especially using artificial blood circulation. The cell link of immunity depression, the B-lymphocytes function inhibition are preserved during 6 months after the operation.

Surgical treatment of acute infective valvular endocarditis (18 years experience).

Background: Infective endocarditis morbidity remains high: 3 to 8 cases per 100,000 of population. Antibiotic therapy is ineffective. Its surgical treatment experience is relatively limited.

Surgical treatment of Wolf-Parkinson-White syndrome during plastic operations in patients with Ebstein's anomaly.

Objective: Ebstein's anomaly is the most common pathology associated with the accessory conduction pathways.

Methods: From January 1990 to August 1999 48 patients underwent surgical repair of Ebstein's anomaly by various plastic techniques. The pathways were identified and characterized at preoperative electrophysiologic mapping in 17 (34.

Aortic aneurysms at the site of the repair of coarctation of the aorta: a review of 48 patients.

Background: Study of the long-term results from 1 to 24 years after coarctation of the aorta repair in 891 patients showed that in 48 (5.4%, Mean age, 30.9 +/- 1.

[New biological vascular prosthesis made of avian trachea].

New biologic prosthesis of the arterial vessels manufactured of the bird trachea was elaborated and approved upon the test bench and experimental conditions. Sufficient mechanical durability and elasticity of the prosthesis was ascertained, alike the possibility of his application for the arterial vessels replacement. New bioprosthesis have such advantages as handiness at work, steadiness for twist and deformation, negligible thrombogenicity, relatively high endothelialization speed, functioning stability and nonreactivity.

[The morphological evaluation of a heart ventricle made from the latissimus dorsi muscle in an experiment].

In experiment of 16 animals the morpho-functional transformations taking place in skeletal-muscular transplant while various methods of artificial heart ventricle creation and his training application were studied. It was established that, as a rule, in autotransplant the reversible structural changes are taking place, what stipulates the necessity of keeping of the "latent" period 14-21 days long between the operation conducted and the beginning of training stimulation of heart ventricles, manufactured of a skeletal muscle.

[The surgical treatment of heart valve defects combined with multiple coronary artery involvement].

The authors analyze 144 surgeries in patients with single and multiple valvular defects combined with multiple involvement of the coronary arteries; multiple (3-4) coronary artery shunting was carried out in 21 patients, the mortality being 19.4%. Recovery of the blood stream in all involved coronary arteries and correction of defective valves were found conducive to reduction of incidence of myocardial infarction and acute heart failure.

[The first experience with A. Jatene's operation in complete transposition of the major vessels in newborn and nursing infants].

The authors analyze their experience gained in the treatment of newborns and infants aged under one with complete transposition of the main vessels; arterial change-over method was employed. Five infants with complete transposition of the main vessels aged 14 to 70 days (27.6 days on an average) weighing 3.

[Method of surgical treatment of mitral valve stenosis depending on the extent of its calcinosis].

On the basis of studying the immediate and long-term results of treatment of 329 patients with calcinated mitral stenosis, the progressive aggravation of the immediate outcome of the operation in II and III-IV degree of mitral valve calcinosis is demonstrated. The data have been confirmed by actuarial analysis of the patients' survival and stability of a good result. The authors consider it expedient to perform mitral commissurotomy only in patients without valvular calcinosis and I degree calcinosis.

[The prognostic assessment of the reversibility of myocardial dysfunction in patients with ischemic heart disease after aortocoronary bypass].

Forty-six patients with ischemic heart disease with considerable dysfunction of the myocardium were subjected before operation of aortocoronary shunting to veloergometry with calculation of indices of the central hemodynamics by the method of tetrapolar rheoplethysmography, echocardioscopy before and after taking nitroglycerin. Close interrelation was noted between the increase of the stroke volume during veloergometry, increased fraction of output after taking nitroglycerin and improved contractile capacity of the myocardium after aortocoronary shunting.

[Progressive changes in the coronary arteries in patients with ischemic heart disease after aortocoronary bypass].

To examine the time course of changes in the coronary arteries in patients with coronary heart disease after aortocoronary bypass (ACB), the authors studied 2 groups of patients: (1) 23 who had conservative treatment and (2) 23 who were selected for ACB. Repeated angiography was performed 14.6 +/- 2.

[The hemostatic system and the status of aortocoronary venous autografts in patients with ischemic heart disease after surgery for direct myocardial revascularization based on autopsy research data].

The study was undertaken to examine the relationship between the major hemostatic factors in the early postoperative period and the status of an autovenous graft in 19 patients with coronary heart disease who died 3 to 40 days after aortocoronary bypass surgery. The hemostatic system was monitored on the patients' admission and during the whole observation. Hypercoagulation was recorded in all patients in the first postoperative hours.

[In vivo analysis of the morphofunctional state of myocardial blood supply in ischemic heart disease].

The patency of coronary arteries and morphofunctional features of myocardial microhemocirculation were studied in 40 males with coronary heart disease (CHD) aged 36-59 using intravital coronary angiography, intraoperative left ventricular biopsies assessed electron-microscopically and by semithin sections. In spite of various impairment of the coronary arteries, there was similar clinical presentation. It was found that in addition to atherosclerosis stenosing the main subepicardial vessels in CHD, there appeared a peripheral barrier for the tissue circulation with defective permeability of the myocardial microvessels.