[Vacuum-therapy of postoperative sternomediastinitis].

AIM: To estimate the results of sternomediastinitis management using vacuum-therapy compared with conventional treatment of such wounds. MATERIAL AND METHODS: We have retrospectively analyzed data for the period from January 2007 to October 2014. The study enrolled 79 patients with infectious complication after cardiac surgery. All patients underwent coronary artery bypass grafting. The first group included 40 patients who received conventional therapy. The second group enrolled 39 patients in whom vacuum-therapy was applied. Patients were comparable in main characteristics. RESULTS: Mortality rate was significantly lower in vacuum-therapy group (2.5% vs. 15%, p=0.05). Similarly duration of hospital-stay in the 2nd group was 29±10 days, in the 1st group - 47±11 days (p<0.01). Incidence of sepsis and other complications was significantly higher in group of conventional treatment. CONCLUSION: Vacuum-therapy for infectious complications after cardiac surgery provided good results including decrease of hospital-stay duration and mortality rate in comparison with conventional management of wounds.

[The relationship between O2 saturation mixed venous blood and pressure in the trunk of the pulmonary artery for healthy people and patients with heart defects].

Investigated the relationship between pulmonary artery pressure (P(LA)) and the oxygen saturation of mixed venous blood (S(V)) in 12 group's of surveyed individuals (1750 men and 1026 women). We have identified a function (P(LA)) between P(LA) = f(S(V)), and a function (S(V)) S(V) = f(P(LA)) was estimated for each group based on direct measurements of P(LA) and S(V). We found, that factors were subordinated to the dependences for a P(LA) = f(S(V)), P(LA) = a x (S(V))(-b), where b = = -0.2284a + 0.6564 men - and b = -0.285a + 1.2947 in women and the other for -S(V) = f(P(LA)), S(V) = c x (P(LA))(-d) where d = -0.251311n(c) + 1.0212; (R2 = 0.8993) men and d = -1.96451n(c) + 2.852; (R2 = 0.9674) women. Each group occupies a position on the curves represented by equations. The subjects with a diagnosis of functional murmur in the heart and patients with congenital stenos is of the aortic valve form a group, provisionally designated as "group norms", which is characterized by its dependence P(LA) = f(S(V)), and -S(V) = f(P(LA)). The men in "group norms" additionally include patients with coronary heart disease. The equation - CO = Cons.O2/(KEK(S(A) - (c x (P(LA))(-d). It relates the P(LA), caused by different reasons, with the corresponding saturation of mixed venous blood, and when the saturation of mixed venous blood is also caused by various factors, set the corresponding P(LA). Interdependent changes in physiological parameters of blood circulation and gas exchange in humans is established equilibrium between systemic and pulmonary circulation.

[Myocardial blood flow in different regions of the heart in patients with ischemic heart disease before and after revascularization]. / Miokardial'nyi krovotok na raznykh uchastkakh serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa do i posle revaskuliarizatsii.

Laser doppler flowmetry was used for the intraoperative study of myocardial blood flow before and after revascularization in 116 patients with 2-3 vessel coronary artery disease and class II-IV angina. In patients without myocardial infarction, with microfocal myocardial infarction, or operated early after myocardial infarction revascularization caused no significant increase of myocardial blood flow. In patients with macrofocal infarction surgery was associated with significant increase of myocardial blood flow. Efficacy of revascularization could be assessed by lowering of flow gradients between various regions of the myocardium.

[Emergency correction of traumatic mitral valve insufficiency under craniocerebral hypothermia]. / Ekstrennaia korrektsiia travmaticheskoi mitral'noi nedostatochnosti v usloviiakh kraniotserebral'noi gipotermii.

Data of emergency correction of traumatic mitral insufficiency in 15 patients after closed mitral commissurotomy under conditions of craniocerebral hypothermia without artificial blood circulation are presented. Prostheses of the mitral valve were made in 3 patients, plastic valve-preserving interventions--in 12 patients. One patient died. The authors consider that in most cases with traumatic insufficiency of the mitral valve after closed commissurotomy it is possible to perform valve-preserving operations, craniocerebral hypothermia being a reliable method of their maintenance.