[A rare case of surgical management of a patient with thoracic aortic aneurysm].

Described in the article is a clinical case of successful surgical management of a male patient diagnosed with a syphilitic-origin aneurysm of the thoracic aorta isthmus, complicated by an aortopulmonary fistula. Also presented herein are the clinical pattern, findings of examination, and treatment policy. This is followed by a detailed description of both the course of the surgical intervention and outcomes obtained.

[Adequate gas exchange in two-sided and combined surgeries on thoracic and abdominal organs].

Method of combined artificial lung ventilation during simultaneous two-sided operations on the lungs was studied in 60 patients. This method is based on traditional ALV with parameters calculated according to functional state of the patient's respiratory system, and additional high-frequency jet pulmonary ventilation. The developed method was not accompanied by any severe disorders of gas exchange and mechanics of ventilation.

[The use of low-molecular heparins in reconstructive surgery of ascending aortic aneurysms].

This paper analyzes the results of the use of enoxaparin for anticoagulant therapy in reconstructions on the ascending aorta (AA) as compared to unfractionated heparin applied previously in the control group. Between 1986 and 2003 a total of 30 patients with AA aneurysms were operated on at the clinic. Insufficiency of the aortic valve with degree II-III regurgitation was present in 25 (83.

[Reducing the need in donor blood in reconstructive surgery of the aorta: using a Cell Saver apparatus].

The possibility of using a Cell Saver "Sequestra 1000" apparatus (Medtronics) for reducing the need for donor blood in reconstructive surgery for aortic aneurism was evaluated within the case study. Thirty-seven patients, who were made different reconstructive procedures on the ascending and abdominal aorta, were examined. Twelve patients with aneurism in the ascending aorta section (AAS) and with insufficiency of the aortal valve were made prosthesis of AAS and aortal valve under extracorporeal circulation (AEC).

[Changes in bioelectric activity and metabolism of the brain during surgery of the aorta under deep hypothermic arrest of circulation].

Bioelectric activity and metabolism of the brain were studied during surgery on the aorta with deep hypothermal arrest of circulation. The study included 9 patients (7 men and 2 women) aged 13 to 66 years. The mean duration of circulation arrest under deep hypothermia was 48.

[Fiber optics oximetry of blood in the upper bulb of the internal jugular vein in heart surgery].

The authors assess the potentialities of a new method; fiber optic oxyhemometry of the blood flowing from the brain (at the level of the upper bulb of the internal jugular vein) during heart surgery. They demonstrate a sufficiently high accuracy of the method. Using it during cardiosurgical operations under artificial circulation, they found it highly informative and sensitive to even suddenly emerging and short-term changes in the ratio of oxygen delivery/consumption by the brain.

[Changes in indicators of brain metabolism in heart surgery patients under normal and hypothermic perfusion].

Metabolism of the brain was studied in 82 cardiosurgical patients operated on under conditions of hypothermal and normothermal artificial circulation (AC). The principal differences in the pattern of changes of cerebral metabolism were observed at the stage of heart connection to the bloodflow, corresponding to the period of warming during hypothermal AC. The detected reduction of oxygen extraction and arteriovenous glucose difference in the normothermal group may be a result of cerebral bloodflow shunting, and more pronounced stimulation of free-radical processes be indicative of the possible injury to cerebral structures in the absence of protective effect of hypothermia.

[The monitoring of brain metabolism as the basis for the control of its adequate protection during circulatory arrest under deep hypothermia].

Monitoring of brain metabolism is used to assess the adequacy of brain cooling during operations performed under conditions of deep hypothermal perfusion and temporary arrest of circulation. Such monitoring consists in continuous recording of hemoglobin saturation of the blood flowing from the brain by fiberoptic oximetry and testing of blood samples collected from the upper internal jugular bulb. A patient is described, who had been operated with good results under conditions of deep hypothermal perfusion and 30-min arrest of circulation.

[Catheterization of the superior bulb of the internal jugular vein and its identification based on blood gas analysis in heart surgery patients].

Methods of catheterization of the upper internal jugular bulb are described. The authors recommend to identify it basing on the difference between gaseous composition of blood samples collected simultaneously at two levels. The informative value of catheterization of the upper internal jugular bulb for assessment of brain metabolism is demonstrated.

[Personal computer-based computer monitoring system of the anesthesiologist (2-year experience in development and use)].

Creation of computer monitoring systems (CMS) for operating rooms is one of the most important spheres of personal computer employment in anesthesiology. The authors developed a PC RS/AT-based CMS and effectively used it for more than 2 years. This system permits comprehensive monitoring in cardiosurgical operations by real time processing the values of arterial and central venous pressure, pressure in the pulmonary artery, bioelectrical activity of the brain, and two temperature values.