[Application of dermal fibroblasts in complex treatment of patients with trophic ulcers of venous etiology].

The authors have analyzed the results of an experimental-clinical investigation devoted to studying the efficiency of local treatment of trophic ulcers at the stage of healing using transplantation of dermal allogenic fibroblasts. The method was proved to accelerate epithelization and to shorten the time of preparing to operations for correction of the venous blood flow.

[The significance of investigation of the left ventricle diastolic function in cardiosurgery].

An examination of 79 patients (main group) with congenital, acquired heart diseases and ischemic heart disease (IHD) without activity of the rheumatoid process and infectious endocarditis and 64 subjects of the same age has shown that in order to improve the assessment of the results of operative treatment of patients with the acquired heart disease and IHD it is necessary to test the diastolic function of the left ventricle (LV) in addition to the systole parameters. Cardiosurgical correction of pathological processes either causing or aggravating LV diastolic dysfunction (overloading LV with the volume or pressure, myocardium ischemia) can either eliminate or reduce its degree. A pathological monophasic filling of LV is a sign of a pronounced systole-diastolic dysfunction of LV and lung hypertension.

[The influence of hereditary thrombophilic mechanisms on the degree of permanent intravascular coagulation in patients with artificial heart valves].

The genotyping of 40 patients with artificial heart valves (AHV) was performed after prosthesis of the mitral and aotic valves with bicuspid AHV (Medinzh-2 and CarboMedics). The patients took phenylin and varfarin. The patients' genotype was estimated by the thrombophylic genes: factor V Leiden (FVL), prothrombin G20210A, methylene tetrahydrofolate reductase C677T, G/A--455FGB, 4G/5G PAI-1, PI A1/A2 GPIIIa.

[Two approaches to correction of disturbed hemostasis in patients with mechanical artificial heart valves at the long-term follow-up].

The investigation of the hemostasis system performed in 47 patients with mechanical heart valves (MHV) at the terms of (3.50 +/- 0.25) years included 30 men and 17 women.

[Hydrodynamic investigations of the current mechanical artificial heart valves].

The work presents results of comparative investigations of the integral hydrodynamic characteristics of the best for today domestic mechanical heart valve (MHV) Medinzh-2 (MI-2) and the turn-disk domestic MHV--LIKS-2, EMIKS (E) and foreign MHV--Medtronic-Hall, Bjork-Shiley (BS), Sorin (SO) and bicuspid valves--St. Jude Medical (SJ), Carbomedics in the stationary and in the pulsatile flows. It was found that according to the main hydrodynamic characteristics including the outlet flow structure, MHV MI-2 was substantially superior to MHV E, BS and SO, and by certain characteristics it approximated to the best foreign MHV SJ.

[Models of inter-group difference of the homeostasis system in patients with artificial heart valves and the set of laboratory parameters].

Patients with artificial heart valves (AHV) belong to a unique multi-component model of the homeostasis system presenting an interaction of activated coagulation processes and pharmacological effects, on the one hand, and genetic peculiarities functioning homeostatic mechanisms, on the other hand. The described method was evaluated on the basis of multi-factor mathematic analysis by information-metry. The data obtained provided for isolating the most information-dense laboratory indices and some genetic polymorphisms describing the shaping of continuous intravascular coagulation of stage III in AHV patients.

[Prophylaxis of thrombosis and thromboembolic complications in patients with domestic mechanical artificial heart valves (AHV) "Medinzh-2" in remote terms of observation].

The observation included 40 patients (20 men and 20 women) with the rheumatic heart diseases acquired at the age of (45.9 +/- 8.7) years after isolated prostheses of the aortal (n = 25) and mitral (n = 15) valves with bicuspid constructions of AHV "MedInzh-2" in remote terms in (2.

[Turbidimetric express method in the assessment of the hemostasis parameters in patients with prosthetic bileaflet heart valves].

Thirty patients of medium (47 +/- 3) years of age with prosthetic bileaflet heart valves without any specific complications of the I-II functional classes and with the postoperative period after mitral (11) and aortal (19) valve replacements during (2.52 +/- 0.48) years were studied.

[Indices of chronic intravascular hemolysis in patients with different prosthetic heart valves in long-term follow-up].

An examination of 153 patients with valve replacement was performed at late stages of (6.8 +/- 0.2) years, in 84 patients the mitral valve replacement (MVR) was fulfilled, in 64--the aortic replacement (AVR) and in 5--two valve replacement were performed.

[Rare causes of the dysfunction of mechanical bicuspid heart valves].

The authors share the observations from their cardiosurgical practice showing that one of the causes of sudden death or of rapid worsening of the state of patients with implanted bicuspid artificial valves might be their dysfunction resulting both from breakage of the hinged mechanisms of the valve with its dislocation and migration and from the disturbed mobility of the valve cusp due to a thrombus formed in the atrium. The observations show that the "ideal" construction of the valve is to be created.

[Should the presence of coiled blood flow in the left heart ventricle and aorta be taken into consideration when constructing artificial heart valves?].

The use of an original device developed by the authors which was introduced in the blood flow in experiments in dogs has confirmed the presence of coiled blood flow in different parts of the aorta. The rate, direction and angle of coiling were calculated. The results obtained suggest that the fact of coiling the blood flow should be taken into account when constructing new models of artificial valves of the heart in order to decrease the energy value of the cardiac output, to prevent injury of the formed elements of blood and thrombogenesis.

[Aortic valve prosthesis and the plication of a dissecting aneurysm of the ascending aorta in a patient with infectious endocarditis against a background of chronic kidney failure and its management by regular hemodialysis].

Some literature data are presented on the problem of cardiac surgery in patients with chronic renal insufficiency under regular hemodialysis and on the specificity of performing operations on such patients under conditions of artificial circulation. The authors describe their first experience of a one-step prosthezing of the aortal valve and plication of the dissecting aneurysm of the ascending part of the aorta in the patient receiving the regular hemodialysis during 5 years as well as the positive results of this original operation in dynamics of the first year of observations.

[Toxicological study of materials for artificial heart valves].

The toxicological study was performed in order to establish the optimum carbon thromboresistant coat of titanium in creating new constructions of the artificial heart valves under conditions of chronic experiments in albino rats. Fine samples of carbon coats made by different techniques were studied. The biological activity of only one coat made by the method of ionoplasmic spraying with using chemically pure carbon target was established.

[Comparative study of hemolysis in patients after implantation of Soviet-made artificial heart valves and spherical and angle-opening disc closing devices].

Intravascular hemolytic parameters were studied in 40 patients after implantation of Soviet-made cardiac values with a ball versus angle-opening disc closing device. It was found that with the angle-opening disc closing cardiac valves "LIKS" and "EMIKS", hemolysis developed considerably more infrequently and was less marked than with ball valves. A significant difference was found between the activity of lactate dehydrogenase and the levels of haptoglobin in the compared groups of patients (p less than 0.

[The effect of intravascular hemolysis on the body of rheumatics with heart valve prostheses].

The rate of intravascular hemolysis and associated complications was studied in 100 patients with rheumatic heart disease within 2 to 20 years after replacement of the heart valves. Hemolysis of varying intensity was recorded in 72% of patients, anemia in 5%, hemosiderinuria in 27%, cholelithiasis in 4%, and sideropenia in 36.8% of the examined.

[Hemolysis indicators in the evaluation of the function of artificial heart valves after heart valve prosthesis].

Hemolysis of blood was studied in two groups of patients: the main group consisted of 75 patients with mitral, aortal and two-valves prostheses; a control group had 15 patients with rheumatic valve defects without prostheses. It was shown that hemolysis was minimal in patients with a satisfactory function of prostheses. It was higher after double prostheses and especially in patients with dysfunction of the valves.

[Determination of the input and output volume of the right ventricle based on cineangiocardiography data].

The authors have developed a method of separate determination of the volumes of the input and output portions of the right ventricle by findings of cineangiocardiography made in two projections. The volume of the input portion had been shown to be 1,23 times as great as that of the output portion. A comparison of measurements of the volumes of the input and output portions and the total right ventricle as a whole will reveal their participation in the compensation of congenital and acquired heart diseases.

[Study of thrombus resistance of materials using the prothrombin consumption test].

The work presents a simple and informative method of the assessment of thromboresistivity of opaque materials by the test of determination of prothrombin consumption in vitro. The average time of prothrombin consumption in the blood after its contact with a glass was 136 +/- 13,3 sec., after the contact with a siliconized glass it was 62 +/- 3,45 sec.