[Analysis of the use of coronary balloon angioplasty in staged treatment of patients with valvular heart disease and stenosing coronary arterial lesion (twelve-year experience)].

The authors present the analysis of their twelve-year experience in staged treatment of patients with combined pathology using coronary balloon angioplasty (CBA). CBA was performed in 83 patients (mean age 61.7 +/- 9.

[Cellular mechanisms of impaired cardiac energetics in patients with dilated cardiomyopathy: decrease in mitochondrial respiration and creatine kinase expression].

The mitochondrial functional characteristics were assessed in the biopsy specimens from patients with various Functional Classes dilated cardiomyopathy (DCMP). The assessment was made by using endomyocardial biopsy specimens weighing 2-4 mg which had been taken from 39 patients aged 19-64 years during coronary ventriculography and cardiac transplantation. The status of mitochondria and the efficiency of mitochondrial creatine kinase functioning were evaluated by recording the respiration of saponin-skinned muscular fibers.

[Triple-valve prosthesis (old problems, new prospects)].

The article analyses 30 operations for prosthetics of the mitral, aortic, and tricuspid valves in patients with trivalve rheumatic heart disease. Twenty-nine patients had a marked organic tricuspid valvular disease. Various models of prostheses (ball, semispherical, biological, disk) were used for replacement of the valves.

[Surgical treatment of ascending aorta aneurysm combined with aortic valve insufficiency].

The article deals with the immediate and late-term results of surgical management of aneurysm of the ascending aorta with aortic incompetence in 33 patients, on whom 34 operations were conducted. The etiology, diagnosis of the disease, and the main moments of the surgical techniques are discussed. For the solution of surgical problems, setting apart patients with dyshistogenetic predisposition is suggested.

[Optimal conditions for preservation of isolated heart using creatine phosphate and vitamin E (an experimental study)].

Functional and structural safety of the myocardium following 6-hour preservation at 4-6 degrees C in ion-balanced cardioplegic solution alone or in combination with pharmacological corrective was evaluated in rats. Langendorff and Neely model of isolated heart perfusion was used. The addition of creatine phosphate in a conservation of 10 mM/l to the solution or donor pretreatment with 70 mg/kg vitamin E was found to potentiate the protective properties of the solution under deep hypothermia.

[Ultrastructural characteristics of anti-ischemia protection of intact and hypertrophic myocardium with phosphocreatinine].

Ultrastructural changes in normal and hypertrophied dog hearts under conditions of total ischemia were studied by electron microscope method. In the control group sings of irreversible damage appeared in 90 min, in the presence of phosphocreatine, 10 mM, these changes became apparent in 120 min. In the hypertrophied hearts signs of the irreversible damages became evident in 60 and 90 min in the absence and presence of phosphocreatine, respectively.

[Retrograde cardioplegia through the right atrium].

The results of retrograde cardioplegia through the right atrium in 50 patients are analysed. The uniform cooling of the myocardium, frequent restoration of the sinus rhythm, and the low hospital mortality rate are evidence of the high efficacy of this method of myocardial protection. Electronmicroscopy showed marked intactness of the myocardial ultrastructure and moderately manifested and reparable reperfusion changes.

[Hemodynamic evaluation of the effectiveness of preservation of subvalvular structures in mitral valve prosthesis].

The article deals with the clinical evaluation of the results of mitral valve prosthetics with preservation of the subvalvular structures in 40 patients and comparative evaluation of the hemodynamic indices after prosthetics with preservation of the subvalvular structures of the posterior cusp and after routine mitral valve prosthetics. The authors show good clinical results in patients after valvar-preserving prosthetics of the mitral valve and essential improvement of left-ventricular contractile activity after such an operation. Comparative analysis showed that the total ejection fraction increased by 10.

[The first clinical experience with heart transplantation].

The article analyses the first clinical experience in orthotopic allotransplantation of the heart at the Scientific Research Institute of Transplantology and Artificial Organs, USSR Ministry of Health, in the period from October, 1986 to July, 1989 (26 transplantations of the heart and one two-stage transplantation of the heart with the use of "Poisk-10M" artificial heart for 3.5 days in the first stage). Eleven patients are alive.

[Prosthesis of the mitral valve with full or partial preservation of the subvalvular apparatus].

The article deals with the first experience in the USSR in using the method of mitral valve prosthesis with complete or partial preservation of the subvalvular apparatus. The operation was performed in 10 patients with mitral insufficiency or combined mitral valvular disease of various etiology. The advantages of employing during operation by this method mechanical prostheses with an obturator element which changes its position are pointed out.

[Hemodynamic characteristics of the EMIKS disk artificial heart valves].

Analysis of the intracardiac hemodynamics have been made in 16 patients before and after making prosthetic appliance of the mitral valve EMIKS. The examination of the patients carried out 8.3 +/- 0.

[Late results of aortic valve prosthesis (a clinico-hemodynamic analysis)].

Long-term results of aortic-valve ball prosthesis implantation in 184 patients, followed up for about 15 years, are presented. The performance of Soviet-made ball prosthesis in the aortic position has been shown to be fairly satisfactory for a long time. Prostheses of this design are also highly wear-resistant and show satisfactory hydrodynamic properties.

[Structural and biochemical characteristics of the effectiveness of intraoperative protection of the myocardium].

Results of morphological and biochemical examination of 153 myocardium biopsies from 42 patients with the intraoperational heart ischemia that developed during the correction of cardiac valves disturbances under the condition of artificial circulation and cardioplegia with the blood based solution are given. Phosphocreatin ("neoton" produced by Schiapparelli Company, Italy) was added as a cardioprotector to the cardioplegic solution in 24 patients. The high efficiency of the drugs for the cardiomyocytes sarcolemma is shown by means of colloidal lanthanum.

[Use of balloon catheters for intraoperative control of resting myocardial pressure during cardioplegia].

Twenty-two patients operated on for aortal, mitral and multivalvular prosthesis under pharmacological cardioplegia were examined for the purpose of monitoring myocardial resting tension by the tensometric method and by using modified balloon catheters. The results demonstrated that the use of the balloon catheters permits making not only qualitative and quantitative assessments of myocardial lesions and a prompt evaluation of the function of the arrested heart but also the initial myocardial contractility and the restoration of myocardial contractility after cardioplegic arrest by controlling the contraction and relaxation myocardial rate.