The frequency of atrial infarction in patients with supraventricular arrhythmias.

Aim      To evaluate the incidence of atrial infarction (AI) based on a retrospective review of 287 case reports of patients with supraventricular arrhythmia and a positive qualitative test for troponin I after pharmacological arrest of arrhythmia; to determine the target localization of lesions and diagnostic signs, that appear in acute ischemic atrial damage, by selective coronary angiography (CA).Material and methods  A retrospective review was performed of 287 case reports of patients admitted to cardiology departments for atrial fibrillation paroxysm with narrow QRS complexes on electrocardiogram (ECG) from 2018 through 2020. At the prehospital stage, verapamil had been administered intravenously with no effect. In the hospital, the sinus rhythm was successfully restored pharmacologically in all patients. Then ECG, repeated qualitative determination of troponin I, echocardiography, and CA were performed.Results 77 (27 %) patients of the study group had AI signs; 27 (9.5 %) of these patients had confirmed AI, and 50 (17.5 %) patients had probable AI. The existence of acute ischemic injury was considered absolutely confirmed in the presence of a combination of ECG changes, positive markers of myocardial damage, and reduced blood flow velocity in the left atrial branch of the sinoatrial nodal artery as shown by CA; in the presence of only ECG and biochemical criteria, acute AI was considered probable. According to selective CA, coronary injuries requiring an intervention were absent, and signs of the above-mentioned artery thrombosis were not visualized. However, the blood flow velocity was reduced to the TIMI II level in 9.5 % of cases; other atrial branches had an extremely small diameter.Conclusion      Atrial infarction needs to be excluded for patients with supraventricular arrhythmias, a characteristic clinical picture, and increased levels of myocardial injury enzymes.

[Echinococcosis of the heart].

Basic clinical and special methods of diagnosis of cardiac echinococcosis are described. Among 12 patients with cardiac echinococcosis 5 patients have been operated and 7 patients have been not. Five of seven non-operated patients died during 1 year due to disruption of the cysts. All 5 operated patients survived. It is demonstrated that surgical treatment should be performed with artificial extracorporeal circulation, and postoperative anti-recurrent anti-helminth therapy is mandatory. Medication before surgical procedures is contraindicated because it leads to cysts disruption with high risk of lethal outcome.

[Sutures and anastomoses of the aorta and large arteries]. / Shvy i anastomozy aorty i krupnykh arterii.

The problems of air-tightness of vascular sutures are discussed. The authors suggested and used in the clinic successfully a double-row buried suture of the anterior wall of the aorta, pulmonary trunk, and femoral artery under conditions of using heparin. The incision for forming the proximal anastomosis in correction of coarctation of the aorta is discussed. A circular suture applied to the aorta and pulmonary trunk with a single thread was developed in experiments and performed in the clinic.

[Intraoperative echocardiography]. / Intraoperatsionnaia ékhokardiografiia.

Combined echocardiography (uni- and two-dimensional, and Doppler) was used during surgery on an open heart. Technological aspects of such examinations are discussed. A method for tricuspid valve annuloplasty is suggested, monitored and regulated by echocardiography on an open heart. Such monitoring will help assess the efficacy of valve-preserving surgery.

[Mitral stenosis and the problem of critical constriction in blood circulation]. / Mitral'nyi stenoz i problema kriticheskogo suzheniia v krovoobrashchenii.

The results of a combined echocardiographic study of 127 patients with mitral stenosis are reviewed. Echocardiographic and hemodynamic parameters are divided into 3 groups with respect to the severity of mitral stenosis. A relationship is demonstrated between mitral opening area and diastolic pressure gradient, as evidenced by dopplerography. The definition of critical mitral stenosis is given. A classification of the severity of mitral stenosis on the basis of two-dimensional echocardiography is offered, that provides indications for surgery.

[Evaluation of the results of closed mitral commissurotomy in the early and late periods after surgery, based on data from a complex echocardiographic examination]. / Otsenka rezul'tatov zakrytoi mitral'noi komissurotomii v rannie i otdalennye sroki posle operatsii po dannym kompleksnogo ékhokardiograficheskogo obsledovaniia.

A study of early and late results of closed mitral commissurotomy demonstrated a 1.8-fold increase in two-dimensional mitral opening area, as compared to preoperative data, largely due to an increase in intercommissural diameter, with intercuspid diameter only slightly changed. In most cases, the operation was not conducive to complete recovery of the mitral opening area that averaged 3 cm2. Impulse doppler-echocardiography showed a 2.1-fold postoperative decrease in diastolic blood pressure gradient. The operation was less effective in cases of mitral calcinosis. One-dimensional investigation demonstrated an insignificant postoperative variation in Vef of the mitral anterior cusp.

[Ultrasonic diagnosis of the function of heart valve prostheses]. / Ul'trazvukovaia diagnostika funktsii klpannykh protezov serdtsa.

Ninety-six patients with mitral, aortic and tricuspid valvular prostheses were investigated echocardiographically, with a total of 116 assessments of prosthetic function between 8 days and 20 years after surgery, using one-dimensional, two-dimensional and dopplerographic techniques. Possibilities of prosthetic dysfunction diagnosis by these techniques are discussed.

[Ultrasonic diagnosis of defects of the tricuspid valve]. / Ul'trazvukovaia diagnostika poroka trikuspidal'nogo klapana.

Experience with echocardiographic diagnosis of a tricuspid defect, using one- and two-dimensional and Doppler echocardiography, is reviewed. Dopplerography is the most informative method for the detection of tricuspid incompetence that enables auscultatory determination and graphical recording of blood regurgitation from the right ventricle to the right atrium. A classification of tricuspid incompetence on the basis of its markedness as assessed by dopplerography is proposed. Dopplerography can also be used for tricuspid valve monitoring and the assessment of early and late results of tricuspid annuloplasty.

[Results of the plastic repair of interventricular septal defects 15 to 20 years after operation]. / Rezul'taty plastiki defektov mezhzheludochkovoi peregorodki cherez 15-20 let posle operatsii.

The authors carried out a comprehensive examination of patients operated on for the radical correction of a ventricular septum defect through the right atrium and with a temporary excision of the septal cusp of the tricuspid valev. The ECG, PCG, and roentgenogram were found to be altered at a long-term period. Examination of the tricuspid valve showed its good function at a long-term period. Practical recommendations on examining this group of patients are offered.