Publications by authors named "Zin'kovskiĭ M"

The method of prediction the enability of closure atrial septal defect before operation or in pre-bypass period during the one and one-half ventricle repair of CHD with hypoplastic right ventricle was presented. The method is based on comparison of the initial blood flow on superior vena cava (SVC) and right-to-left shunt at atrial level. Defect can be closed if flow on SVC and shunt flow are approximately equal.

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Typical three-atrium heart constitute a rare inborn heart failure, in which pulmonary veins drain into the proximal additional camera of the left atrium, separated from distal left pericardium cavity of it own by diaphragm, in which there is one or more restrictive apertures. Of 6770 patients, consecutively operated on by one surgeon, in 15 (0.21%) ageing from 7 mo to 30 years the three-atrium heart was revealed.

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Complete cavapulmonary conjunction (CCPC) was done in 27 patients, in 3 of whom the tricuspid valve atresia and in 24--various forms of the heart only ventricle. In the early postoperative period 7 (25.9%) patients died.

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Two-directional cava-pulmonary anastomosis was done in 35 patients with a inborn heart failure, ageing from 10 months to 11 years. In 29 patients the significant improvement of their state was noted. The level of arterial blood saturation with an oxygen have rised up to (90.

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In 23 of 154 patients with congenital mitral valve (MV) insufficiency the MV prosthetics was conducted, and in 23-valve-preserving reconstructive operation. Operative procedures were depicted, early and late follow-up results were analyzed. After the valve-preserving operation conduction hospital lethality was 8.

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The frequency and factors favouring the development of cardiac rhythm disorders were studied in 306 patients operated on radically for Fallot's tetralogy (follow-up: 6 months--29 years). This complication was found in 99 patients (32.3%).

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The mechanisms and causes of the development of residual shunts after closure of atrial septal defects were studied on the basis of the analysis of the results of 17 reoperations for this complication. It was established that errors of surgical correction were the most frequent causes of residual shunts: an attempt to close large defects with sutures, use of a graft smaller than the size of the defect, concomitant anomalies which caused the reshunting, and incomplete correction of the defect.

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It was found that in isolated infundibular stenosis of the pulmonary artery a mass of muscle-fibrous tissue creates an obstacle to blood flow in the right ventricle. Morphogenetic regularities of compensatory and adaptive reactions in isolated infundibular stenosis are similar to those observed in hypertrophic cardiomyopathy. It may be suggested that abnormalities in the structure of the hypertrophied myocardium in isolated stenosis of the right ventricle infundibulum is a result of a fundamental error in the cardiac morphogenesis and not a reflection of increase of the degree of cardiac hypertrophy.

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A quantitative method has been developed for the assessment of the summary section area of the main pulmonary artery branches in Fallot's tetrad, and its value for the prediction of radical surgery outcomes is demonstrated. Shunting operations are shown to have a considerable positive effect on the expansion of pulmonary arterial bed. The range of indications for complete correction of the defect is determined, and management strategy is specified for patients with narrow pulmonary arterial branches.

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