[A comparative evaluation of methods of radiologic diagnosis in determining the functional status of the right ventricular myocardium in tetralogy of Fallot]. / Sravnitel'naia otsenka metodov luchevoi diagnostiki v opredelenii funktsional'nogo sostoianiia miokarda pravogo zheludochka pri tetrade Fallo.

In order to study the informative value of two-dimensional echocardiography (EchoCG) in the assessment of right ventricular function in Fallot's tetrad the results of echocardiography were compared with those of angiocardiography. A total of 40 patients aged 2 to 13 with the cyanotic form of the defect were investigated. Functional indices were calculated using Simpson's rule. The highest correlation in comparing echo- and angiocardiography results was obtained for the end-diastolic volume (r = 0.94), a slightly lower one--for the end-systolic volume (r = 0.92). The mean value of the right ventricular ejection fraction (EF) by the results of echocardiography was 0.62 +/- 0.05 +/- 0.08, by the results of angiocardiography--0.62 +/- 0.05 +/- 0.09. The correlation coefficient characterizing the proximity of EF values, obtained by the above methods, was 0.89. The greatest divergences in the results were noted in the calculation of the minute volume. It can be accounted for by the patients' different state at the time of invasive and non-invasive investigation. A high informative value and accuracy of two-dimensional echocardiography was proved in the assessment of right ventricular function in Fallot's tetrad.

[Ways of improving the diagnosis and prognosis in vasorenal hypertension]. / Puti uluchsheniia diagnostiki i prognozirovaniia vazorenal'noi gipertenzil.

Atherosclerosis, aorto-arteritis and fibromuscular dysplasia are the most common causes of vasorenal hypertension. Determination of plasma renin activity is a valuable diagnostic test at early stages of vasorenal hypertension. HLA studies demonstrated significantly elevated antigens B8 and B12 in patients with essential hypertension, and antigen A9 in patients with affected renal arteries. These findings may expand the possibilities of differential diagnosis for the selection of patients, eligible for angiographic investigation. A less than three-years duration of the disease in the presence of high plasma renin activity is a favorable prognostic criterion.

[Fibronectin level of the blood plasma of patients with congenital heart defects]. / Uroven' fibronektina v plazme krovi bol'nykh vrozhdennymi porokami serdtsa.

Enzyme immunoassays have shown mean fibronectin (FN) level to be 241.0 +/- 15.1 micrograms/ml in normal children between 2 and 15 years of age. Similar assays in 57 patients with congenital heart diseases (CHD) before and after surgery demonstrated preoperative FN decrease in 56% of patients, that was directly related to the extent of hemodynamic disorders, while postoperative FN level depended on the range and type of surgical trauma and the presence of inflammatory or suppurative-septic complications. Within 3 postoperative days, FN drops below normal level in 95% of patients. In spite of therapeutic use of blood and blood components, FN deficiency was not compensated for until day 10 after surgical correction of the valvular defect.

[Echocardiography in the diagnosis and evaluation of the results of the surgical treatment of interatrial septal defects in adult patients]. / Ekhokardiografiia v diagnostike i otsenke rezul'tatov khirurgicheskogo lecheniia defektov mezhpredserdnoi peregorodki u vzroslykh bol'nykh.

Pre- and postoperative echocardiographic findings in 67 patients above 18 years of age with atrial septal defects were compared with hemodynamic data obtained at catheterization of heart cavities. No possible ways of accurate noninvasive assessment of arteriovenous discharge were found. Echocardiographic parameters of the followed-up patients returned to normal within 3 to 4 years after surgical correction of the defect. In some cases where mitral prolapse was found preoperatively, angiographically documented mitral regurgitation was seen at long-term follow-up.

[T and B lymphocyte function of patients with infectious complications after surgery for congenital heart defects]. / Sostoianie T- i B-limfotsitov u bol'nykh s infektsionnymi oslozhneniiami posle operatsii po povodu vrozhdennykh porokov serdtsa.

The parameters of T- and B-lymphocyte system were studied in 65 patients with congenital heart defects aged from 2 to 31 years with infectious complications after operation. The investigation was performed before operation and in the course of the postoperative period. Patients with infectious complications were shown to have more considerable suppression of cell and humoral immunity before operation than those without infectious complications. The parameters concerned were found to be distinctly decreased in the early postoperative period. Two weeks after operation no normalization of the immune parameters were noted.

[Experience with repeated operations in the late periods after aortic prosthesis for coarctation]. / Opyt povtornykh operatsii v otdalennye sroki posle protezirovaniia aorty po povodu koarktatsii.

Six repeated operations were performed in periods of one and a half to thirteen and a half years after aortic prosthetics in five patients and shunting in the region of the coarctation in one patient. Severe deformity of the prostheses was revealed during the operation in all cases. Total normalization of the correlation between arterial pressure on the upper and lower extremities was achieved in five persons as a result of the operation. The causes of deformities of the prostheses, the peculiarities of the technique of repeated operative interventions, the methods for correcting circulatory disorders and the indications for reoperations are discussed.

[Indications for hypothermia in the surgery of congenital heart defects and the results of its use]. / Pokazaniia k gipotermii v khirurgii vrozhdennykh porokov serdtsa i rezul'taty ee primeneniia.

The authors operated 1056 patients on "dry" heart under the conditions of hypothermia. The total lethality constituted 4.5%. Since 1970 they have been applying craniocerebral hypothermia method using the apparatus "Kholod-2F". Secondary failures of the interatrial septum and valve stenosis of the pulmonary artery in patients aged from 18 to 20 are the most common indications for operation. 450 and 248 patients, respectively, were operated upon; lethality was 3.7% and 4%. The 16 years' experience with the superficial hypothermia in the correction of congenital heart diseases has proved this method to be highly effective and economical one, allowing to obtain quite favourable results after a thorough preoperative diagnosis and strict selection of patients.

[Surgical treatment of aortic coarctation in adults]. / Khirurgicheskoe lechenie koarktatsii aorty u vzroslykh bol'nykh

During a 18-year period the authors operated 305 patients with aortic coarctation, the mortality being 2.2%. Sixty three patients (20.6%) aged from 20 to 40 years were operated upon with the mortality in 7.9%. A direct anastomosis of the aorta was constructed in 31 patients, alloprosthesis of the aorta was employed in 23 cases, indirect isthmoplasty--in 8 cases, in one case an aortic prosthesis was replaced. The most frequent intra- and postoperative complication was intrapleural hemorrhage. In estimating the efficacy of surgery within the terms up to 14 years the best results were obtained after an end-to-end anastomosis.