[A survey of medical equipment displayed at the "Healthcare-2004" exhibition].

Surveyed in the paper is medical equipment displayed, November 29-December 3, 2004, in the Exhibition Hall in Krasnaya Presnya within the framework of the "Healthcare, Medical Equipment and Drugs-2004" Exhibition. The survey is made for the below categories of medical equipment: instruments and apparatuses; X-ray, neonatal, ophthalmologic and stomatological equipment; medical instruments; laboratory medical equipment; equipment for rehabilitation of patients and disabled and mobile medical equipment. A conclusion is made on that a lot of novel high-quality and high-tech medical equipment has emerged in the Russian market. The diversified equipment displayed at the Exhibition enables any medical facility to choose for its needs the most appropriate medical equipment, instruments and spares.

[Surgical treatment of different variants of tachycardia]. / Khirurgicheskoe lechenie nekotorykh vidov takhikardii.

The paper presents a generalized experience in the surgical treatment of patients with frequent attacks of paroxysmal tachycardia associated with additional cardiac conduction pathways, that are not affected by the drug treatment. The results are described of 27 operations of destruction of anomalous cardiac conduction pathways. The use of a special ultrasound destructor permits the surgeon to perform the operation on the functioning heart, thus providing maximal radical surgery with minimal cardiac trauma and best effects.

[Arrhythmia in patients after heart transplantation]. / Narusheniia ritma u bol'nykh posle transplantatsii serdtsa.

Holter monitoring was performed in 15 patients surviving over 3 months after homotopic cardiac transplantation. The frequency and types of arrhythmias occurring in the grafted innervated heart were studied according to its postoperative period duration. The follow-up lasted 3 to 29 months. Supraventricular arrhythmias were detected in 80%, whereas ventricular ones were found in 86.7%. Ventricular arrhythmias accompanied chronic graft rejection in 2 patients. It was ascertained that Holter monitoring was of greater diagnostic value than routine ECG recording. Innervation is not essential in the occurrence of cardiac arrhythmias.

[The quality of life and survival of patients with an implanted pacemaker (the results of long-term observation)]. / Kachestvo zhizni i vyzhivaemost' bol'nykh s implantirovannym élektrokardiostimuliatorom (rezul'taty dlitel'nogo nabliudeniia).

110 patients with implanted pacemaker were followed up for 1 to 10 years until a complete atrioventricular block. Permanent pacemaking is effective as it eliminates or reduces many symptoms, prolongs active life, improves quality of life in 81.4% of patients. Some of the patients were able to resume work.

[History of development of manufacture of implanted pacemakers: plans and reality]. / Istoriia razvitiia proizvodstva implantiruemykh élektrokardiostimuliatorov -- plany i real'nost'.

The paper deals with the history of design and development of implanted pacemakers, emphasis is also laid on electric neuromyostimulators. Present-day problems and prospects in this area are touched upon.

[The "Pulse" computer-based analyzer for measuring the pulse-wave and electric cardiac activity]. / Komp'iuternyi analizator pul'sovoi volny i élektricheskoi aktivnosti serdtsa "Pul's".

The paper deals with a device designed for the express-examination of the cardiac-vascular system through reading and processing the synchronously incoming electrocardiosignal and pulse-wave. The equipment is convenient for monitoring intraoperatively the functions of pacemaker due to its ability to select an optimal regimen not only for ECG but also for the pulse-wave. The new method of registering the pulse-wave by a miniature fiber-optic pressure sensor is described.

[Problems of thrombogenesis and destruction of the superficial layer of implanted artificial heart valves]. / Problemy tromboobrazovaniia i razrusheniia poverkhnostnog o sloia implantirovannykh iskusstvennykh klapanov serdtsa

Experience with the use of artificial cardiac valves has revealed basic shortcomings of their designs, viz. their hemodynamic inadequacy to natural cardiac valves and thrombogeneity. The thrombogenesis is held to be qualitatively linked with the turbulence of the blood stream on the prosthesis, but the mechanism of this phenomenon has not been explained so far. Metallographic investigations of the titanium valve surfaces, with the valves having been operative in the human body over periods of from 8 hours to 80 days, demonstrated destruction of the superficial layer of the valve's cell. The surface layer of the metal is structurally changed to a depth of 0.05 mm, has a spongy texture and is readily detachable from the bulk of the metal. The presumed cause of erosion is considered to be saturation of the surface layer with gases, possibly as a result of cavitation within the prosthesis zone.

[Effect of electrochemical treatment of heart valve prostheses on their antithrombogenicity]. / Vliianie élektrokhimicheskoi obrabotki protezov klapanov serdtsa na ikh antitrombogennost'.

For producing artificial cardiac valves possessing high antitrombogenic properties, two methods of their treatment were investigated: mechanical and electrochemical. It was found that electrochemical polishing reduced the possibility of thrombogenesis.

[Topical diagnosis of disorders of the heart conduction system and surgical treatment of patients with supraventricular tachycardia]. / Topicheskaia diagnostika narushenii funktsii provodiashchei sistemy serdtsa i khirurgicheskoe lechenie bol'nykh s supraventrikuliarnoi takhikardiei.

Questions of preoperative diagnosis of the place of the disturbance of the normal heart excitation, spread of this excitation and distribution of places of the most frequent disposition of these foci in the heart depending on the pathology of the process are discussed. Sixty six patients with different kinds of tachicardia were examined, 40 patients were operated upon under conditions of artificial blood circulation. The examination of patients was performed by both routine and special methods (such as electrophysiological examination with the registration of 9 points of different parts of the heart simultaneously).

[Reduced paired stimulation in patients in the early postoperative period after an open-heart surgery]. / Urezhaiushchaia parnaia stimuliatsiia u bol'nykh posle operatsii na otkrytom serdtse v rannem posleoperatsionnom periode.

The authors provide the technique of underdriving paired ventricular stimulation as a variant of treating drug-resistant tachycardias and a formula of calculating rhythm inhibition and the impulse delay. Basing on the stimulation pathophysiology and positive shifts in hemodynamics, the validity of this stimulation, its advantages and indications are inferred.

[Coronary circulation in healthy men during postural changes and decompression of the lower half of the body]. / Koronarnoe krovoobrashchenie zdorovogo cheloveka vo vremia postural'nykh vozdeistvii i dekompressii nizhnei poloviny tela.

The effect of postural changes (ortho- and antiorthostatic tests) and LBNP on coronary circulation was investigated in 11 healthy male test subjects. Volume blood flow velocity and pressure were measured and blood flowing from the heart was withdrawn using a Ganz catheter implanted into the coronary sinus. A thin Teflon catheter was implanted into the brachial artery. When the test subjects were transferred from the recumbent to the head-up position, their left ventricular oxygen consumption decreased by 3.2 ml/min (21%) and coronary blood flow by 23.8 ml/min (19%), while coronary vascular resistance increased by 32%. When the test subjects were transferred from the head-up to the head-down position (at -15 degrees), coronary oxygen consumption and blood flow increased by 5.5 (46%) and 45.3 (44%) ml/min, respectively, and coronary resistance decreased by 36%. In this situation the LBNP test (-30 mm Hg for 20 min) caused a reduction in oxygen consumption and coronary blood flow by 4.4 (25%) and 37.3 (25% 7 ml/min, respectively, and an increase in coronary resistance by 58%.

[Recommendations for implanting cardiac pacemakers in bradycardia]. / Rekomendatsii dlia implantatsii élektrokardiostimuliatorov pri bradikardiiakh.

The paper gives recommendations for cardiologists and cardiac surgeons who are engaged in working out indications, choice of the type and mode of cardiac pacing. Based on the understanding of the great importance of nomenclature documents concerning the development of indications for pacemakers implantation, the Working Group of the Expert Committee, Ministry of Health of the Russian Federation and Russian Academy of Medical Sciences, for implantable antiarrhythmic devices and electrophysiology has developed recommendations on pacemaker implantation in acquired atrioventricular (AV) block, in AV-block after myocardial infarction, chronic bi- and tri-fascicular block, sinoatrial nodal dysfunction, hypersensitive carotid sinus syndrome, neurovascular syndromes, as well as in childhood bradyarrhythmias. In developing the recommendations, the authors have used their own 25-year experience in implanting pacemakers and the recommendations proposed by the Working Group of the American College of Cardiologists and the American Association of Cardiologists in 1984 and 1991 for implanting pacemakers in bradyarrhythmias. The proposed recommendations define indications and contraindications for implantation of up-to-date pacemaker models and determine the behaviour policy of a specialist in selecting patients with bradyarrhythmias for the optimal pacing mode, which suggests a compulsory certification of the centers engaged in implanting pacemakers in bradyarrhythmias.

[The first clinical experience with heart transplantation]. / Pervyi klinicheskii opyt transplantatsii serdtsa.

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. Follow-up periods: maximum over 2.5 years, minimum 3 months. Sixteen patients died in different periods (up to 12 months). Three-component therapy (cyclosporine A, methylprednisolone, azathioprine) was applied for immunosuppression. The authors analyse the problems of the selection of potential recipients (indications and contraindications) and donor, the optimum surgical techniques, complications of immunosuppressive therapy, and infectious complications. The first clinical experience in two-stage transplantation of the heart is analysed. The first experience in transplantation of the heart in patients allows the conclusion that the use of this method for the management of the terminal stage of congestive cardiac insufficiency is a reality.