INFLUENCE OF PERMANENT PACING OF THE ATRIA FROM UPPER ANTERIOR AREA OF INTERCARDIAC SEPTA (AREA OF BAKHMAN'S FASCICLES) ON THE PART OF AMOTIVATIONAL VENTRICLE STIMULATION.

This research includes 74 patients with syndrome of the sinus node asthenia. The application of permanent bilocular pacing was indicated for these patients. An atrial electrode was located in the right atrial auricle in 37 patients and it was in the area of Bakhman's fascicles in other 37 patients. All the patients had a stimulated atrio-ventricular delay on 250 ms, but sensing delay was shorter on 20 ms. Given data were analyzed after operation in the periods of 6 and 12 months. Cumulative percent of ventricular stimulation was significantly less in the group with electrode in the area of Bakhman's fascicles (6%) as compared with the group where electrode installed in the right atrial auricle (41%) after 6 months. There were 4% in comparison with 43% after 12 months. The localization of atrial electrode in the area of Bakhman's fascicles led to reduction of cumulative percent of ventricular stimulation on 35% after 6 months and on 39% after 12 months. Permanent pacing in the area of Bakhman's fascicles could be an effective mode to decrease the part of amotivational stimulation of the right ventricle.

[Intraoperative reservation of auto-blood in surgical treatment of ischemic heart disease]. / Intraoperatsionnoe rezervirovanie autokrovi u bol'nykh pri khirurgicheskom lechenii ishemicheskoi bolezni serdtsa.

The article presents results of using the method of intraoperative autotransfusion in surgical treatment of IHD. It was shown that in patients with IHD intraoperative reservation of 400 ml of autoblood at the stage of surgical access (prior to infusion of heparin) during coronary shunting did not lead to disturbances of hemodynamics, gas exchange and oxygen-transporting function of blood. The following transfusion of predonated autoblood at the final stage of operation promotes the early reestablishment of the circulating erythron and allows to reduce the requirement of transfusion of the donor erythrocyte concentrate by 26.1%, and chilled plasma--by more than 1.5 times.

[Intravascular photohemotherapy in the complex prophylaxis of purulent-septic complications after coronary shunting]. / Vnutrisosudistaia fotogemoterapiia v kompleksnoi profilaktike gnoino-septicheskikh oslozhnenii posle koronarnogo shuntirovaniia.

The article presents results of treatment of 78 patients with the history of coronary bypass operations for ischemic heart disease. There were 48 patients with high risk factors of the development of pyo-septic complications. Among them there were 27 patients treated by complex postoperative therapy including intravascular photomodification of blood. The intravascular irradiation of blood was shown to have a positive influence upon the development of the early postoperative period in this category of patients. The immunomodulating effect was noted due to a greater amount of activated lymphocytes and T-helpers in blood. The positive dynamics of immunological indices were in correspondence with the data of the clinical state, pyo-inflammatory complications were not registered in this group of patients. Early (on the 3rd-5th days) inclusion of the intravascular irradiation of blood in the complex postoperative therapy is thought to be expedient for the patients with high risk of pyo-inflammatory complications.

[The organization of the donation of autologous blood and its components in cardiac surgery]. / Organizatsiia autodonorstva krovi i ee komponentov v kardiokhirurgii.

The article analyzes an experience with the organization of autodonation of blood and its components in surgical treatment of 305 patients with congenital and acquired defects and ischemic heart disease. Methods of plasmacytapheresis and cryopreservation used at the terms from 3 days to 12 months before operation allowed storage of the autologous components of blood in 41.2% of the patients having indications for autodonation. In 29.1% of the observations the autotransfusion media were reserved under the outpatient clinic conditions which resulted in shorter terms of treatment at the hospital. The number of unfavorable reactions during the donation in patients did not exceed analogous parameters in regular donors. Autohemotransfusions 3-5 times reduced the volume of transfusions of the allogenic blood components and they were completely avoided in 20.1% of the patients.

[Comparative characteristics of reactions of central hemodynamics to the exfusion of blood and plasma in surgical diseases]. / Sravnitel'naia kharakteristika reaktsii tsentral'noi gemodinamiki na oksfuziiu krovi i plazmy pri khirurgicheskikh zabolevaniiakh.

Complex clinico-laboratory and functional examinations of 102 patients have been made who had heart diseases, lung carcinoma, benign tumours of the lungs and mediastinal organs. Autoblood of 34 patients was prepared in the preoperative period (450-600 ml). A single taking the plasma by the method of double plamapheresis (500 ml) was performed in 48 patients. Autoplasma was prepared in 20 patients by the apparatus PF-0.5 (1200 ml). It is concluded that patients without pronounced insufficiency of blood circulation and anemization can easily endure exfusions of considerable volumes of blood and plasma.