[Hemodynamic parameters and saturation of the cerebral cortex blood with oxygen during extracorporeal circulation in heart surgery].

Sixty-three patients were intraoperatively examined during heart surgery with extracorporeal circulation (AEC). They were operated on for an affected heart-valve apparatus (AHVA) and ischemic heart disease (IHD). There was a perioperative monitoring of central hemodynamics, pressure in the bulb of superior jugular vein (BSJV) and electroencephalography (EEG).

[Cerebral oximetry during cardiac surgery under extracorporeal circulation].

The time course of changes in rSO2 were studied in 58 patients during the uncomplicated course of cardiac operations under extracorporeal circulation (EC) and moderate hypothermia. rSO2 was also compared with central hemodynamic parameters, bioelectrical cerebral activity, and hemoglobin oxygen saturation of the bulb of the internal jugular vein (jbSO2). In the pre- and postperfusion period there was a significant correlation of rSO2 and jbSO2 (p = 0.

[The left atrial-femoral bypass in operations on the descending aorta].

Fifteen patients were operated on for aortic aneurysms and were fitted with prostheses of the thoracoabdominal portion of the aorta in March 1997-February 1999. The operations were performed under conditions of a left atrial-femoral bypass with a centrifuge pump with a working heart. The patients were divided into 2 groups.

[Modezhel' erythrocyte preservative as an experimental and clinical blood substitute].

The model of hemorrhagic shock in dogs was used to show that the infusion of "Modegel" normalizes the arterial pressure, substantially increases the minute volume of blood circulation. The circulating blood volume rises up to the initial level at the expense of the increased plasma volume. "Modegel" gives stable correction of the acid-base balance of blood.

[Comparative assessment of temperature of the myocardium during its protection by 2 methods in aortocoronary bypass].

Eighty-eight patients operated on for coronary heart disease were examined. Continuous irrigation of pericardial cavity with circulating cold solution in combination with antegrade cardioplegia was used in 53 patients, antegrade cardioplegia with external cooling of the heart by icy mass in the rest 35. Intensive external cooling provided a stable temperature of the myocardium during clamping of the aorta.

[First experience in normo-thermal artificial circulation with constant warm blood cardioplegia].

Normo-thermal artificial circulation (NAC) with constant thermal blood cardioplegia (CTBC) was carried out for the first time in Russia in 12 coronary patients subjected to surgical revascularization of the myocardium. Artificial circulation device with the vesical type oxygenator was used for NAC. For CTBC, systems for delivery of the cardioplegic solution and blood from the oxygenator in 1:4 ratio were used.

[The protection of the myocardium with a circulating cold solution during aortocoronary bypass operations].

Forty-three patients operated on under conditions of aortocoronary bypass were examined. In 29 of them continuous circulation of cold solution in pericardial cavity was combined with antegrade cardioplegia. In 14 routine technique of external myocardial cooling with snow and antegrade crystalloid cardioplegia was employed.

[Our initial experience of protecting the myocardium by irrigating the pericardial cavity with a circulating cold solution during operations with artificial circulation].

In 21 patients with coronary heart disease, a procedure of protecting the myocardium was used during cardiac surgeries via irrigation of the pericardial cavity with circulating cold solution in combination with cardioplegia into the aortic root. The application of the procedure maintained stable myocardial temperature from 10.26 +/- 1.

[Practical aspects of cardioplegia].

Concentrations of the ingredients have been analysed in a nonstandard cardioplegia solution (CS) and CS from St. Thomas Hospital at the outset before CS introduction into the coronary vessels of patients under cardioplegia. It has been shown that the use of nonstandard CS was accompanied by undesirable variability in ingredient concentration, which to some extent may be accounted for by the use of incompletely unfrozen CS.

[The Soviet colloid modegel as a component of a perfusion medium used in surgery with extracorporeal circulation].

The results of the application of a new Soviet colloid solution modegel in cardiopulmonary bypass surgery in 50 patients have been analysed. The data obtained have been compared to those of control patients who were administered gelatinol instead of modegel. Modegel ensures optimal basic plasma electrolyte content, colloid-osmotic pressure and osmolality during perfusion.

[The concentration of calcium and its fractions during heart surgery using extracorporeal circulation].

Changes in the concentration of calcium and its fractions have been studied in 115 patients subject to standard bypass techniques. It has been found that calcium homeostasis disturbances do really develop and are caused by the use of solutions that are not balanced with blood in their calcium content. The main source of calcium in hemodiluents was gelatinol.

[The content of calcium and magnesium in official Soviet solutions used in extracorporeal circulation, anesthesia and resuscitation].

Total calcium (CaT) and total magnesium (MgT) levels have been determined in 21 solutions used in cardiopulmonary bypass surgery and manufactured in the USSR. It has been found that a great number of solutions differ in CaT content from human plasma. Some solutions contain Ca, which is not required by the prescription.

[The use of the new Soviet crystalloid mafusol as a hemodiluent in surgery using artificial circulation].

Two Soviet-made polyionic crystalloid solutions--mafusol, containing sodium fumarate and lactasol, containing sodium lactate--were compared as hemodiluents used during cardiopulmonary bypass surgery. It has been shown that both solutions are adequate preparations quite effective as a crystalloid component of the perfusion medium in assisted circulation.

[Experience in hemoconcentration by ultrafiltration in operations using artificial circulation at the All-Union Scientific Center of Surgery of the USSR Academy of Medical Sciences].

The article deals with the results of using ultrafiltration hemoconcentration in 649 operations conducted on the open heart with extracorporeal circulation at the All-Union Scientific Center of Surgery, USSR AMS during 1983-1989. The method allows control of hemodilution and colloid-osmotic pressure of plasma during the indicated interventions, lessens the loss of blood, and reduces the expenditure of donor blood.

[Selective ultrafiltration: a new variant of hemoconcentration during surgery with artificial circulation].

The authors provide an experience with a novel alternative of ultrafiltration hemoconcentration applied to 26 patients in surgery involving extracorporeal circulation. The advantages of the new procedure are maintenance of higher colloid-osmotic pressure, prevention of hyperglycemia, lower body elimination of biologically active compounds and drugs than those observed during the routine procedure of ultrafiltration comprising extracorporeal circulation.

[Magnesium levels in the blood of patients during surgery using cardiopulmonary bypass].

The use of gelatinol as a basic diluent for perfusion caused hypermagniemia (an increase in total magnesium plasma level-MgT-to 1.72 and in its ionized fraction -Mg2+- to 0.93 mmol/l) which persisted in the early postoperative period.

[Middle molecule compounds of the plasma in heart surgery patients in operations with artificial circulation and blood ultrafiltration].

Venous plasma middle molecule compounds (MMC) were determined in 63 cardiosurgical patients, operated on for acquired heart diseases or coronary disease, with assisted circulation (AC) and with or without blood ultrafiltration (BUF). Intraoperative MMC level was superior to that of normal donors, and tended to decrease during AC, while BUF had basically no effect on MMC content, in spite of the latter's withdrawal with the ultrafiltrate.