[Experience in catheter balloon dilatation of the heart valves abd aorta in 1024 patients]. / Opyt kateternoi ballonnoi dilatatsii klapanov serdtsa i aorty u 1024 bol'nykh.

The paper gives the results of catheter balloon valvuloplasty (CVP) in 1042 patients: in 557 on the mitral valve, 148 on the aortic valve, 42 on the tricuspid valve, 211 on the pulmonary valve, 84 for aortic coarctation. It analyzes the late outcomes of CVP in 157 patients with mitral stenoses, 31 with congenital aortic ostial stenosis. The paper also demonstrates the good efficiency and relative safety of CVP.

[Changes in clinical-instrumental parameters in patients with mitral stenosis after balloon catheterization valvuloplasty of the mitral valve]. / Izmeneniia kliniko-instrumental'nykh pokazatelei u bol'nykh mitral'nym stenozom posle kateternoi ballonnoi val'vuloplastiki mitral'nogo klapana.

The results of mitral valvuloplasty using a balloon catheter were presented for 104 patients with mitral stenosis. Instrumental measurements and clinical symptoms were evaluated before the operation, 6 and 12 months after it (62 and 42 patients, respectively). The balloon dilatation has increased mitral orifice from 120.5 +/- 5.8 to 333.88 +/- 7.45 mm2, transmitral diastolic pressure gradient decreased from 22 +/- 1 to 7.91 +/- 0.6 mm Hg. All the patients benefited clinically: cough, blood spitting, lower limb edemas, protodiastolic murmur disappeared, dyspnea noticeably reduced. NYHA functional class I-II was established in 85% of the patients. The highest effect was achieved in patients with isolated mitral stenosis.

[Catheter balloon valvuloplasty in mitral stenosis (choice of surgical methods and evaluation of its results)]. / Kateternaia ballonnaia valvuloplastika pri mitralnom stenoze (vybor sposoba operatsii i klinicheskaia otsenka eë rezultatov).

Clinico-experimental study was undertaken for the choice of the optimal method for radiosurgical correction of the disease. Catheter balloon valvuloplasty (CBV), suggested by V. A. Silin and V. K. Sukhov with the use of balloon catheters of their design was found to be the most effective and safe method. This method was used to operate on 265 patients with mitral stenosis and various degree of affection of the valvular apparatus and complications in the form of calcinosis of the valve and cardiac fibrillation. Thirteen of the patients were operated on in pregnancy. CBV produced a positive therapeutic effect in more than 95% of patients. Increase of the mitral orifice area by 2.2-3.4 times was attended by a corresponding reduction of the diastolic pressure gradient at the mitral valve and systolic pressure in the pulmonary artery. The increase in the area of the mitral orifice and the positive changes of the hemodynamics values were more marked in patients with severe stenosis. The small number of complications (up to 9.5%) and the low lethality (up to 0.86%) allow the CBV method to be recommended as one of the main methods of surgical correction of mitral stenosis.

[The endovascular correction of aortic coarctation]. / Endovaskuliarnaia korrektsiia koarktatsii aorty.

The endovascular balloon dilatation of the aorta coarctation performed on indications and at the optimal terms is the radical correction of the defect with a pronounced positive effect in 90% of 43 patients. No aneurysms and restenoses were found. Retained collaterals allow avoidance of the abdominal syndrome and paradoxical hypertension. Contraindications for catheter angioplasty are thought to include agenesia or considerable hypoplasia of the aorta, the absence of the aorta lumen in the zone of coarctation, its considerable length and the presence of prestenotic aneurysms. A short and noncomplicated postoperative period makes the method sufficiently economical.

[Complications of catheter-balloon valvuloplasty (analysis of their causes and the methods of prevention and treatment]. / Oslozhneniia kateternoi ballonnoi val'vuloplastiki (analiz prichin, sposoby profilaktiki i lecheniia).

The authors analyse the results of 1,404 operations of catheter-balloon valvuloplasty in stenoses of the pulmonary, aortic, and mitral valves. The experience was accumulated by the leading heart surgeons of the country from 1984 to 1990. The total number of complications was 77 (5.4%), 23 (1.6%) of them were fetal. The least number of complications (1.88%) occurred in catheter-balloon valvuloplasty in pulmonary stenosis, 1% were fetal. Complications in aortic stenosis were encountered in 11.3% of cases, 4.8% were fatal. The greatest number of complications (44) were recorded in mitral stenosis with a relatively low mortality (2.7%). The authors distinguish unspecific complications connected with the use of standard diagnostic catheters and instruments, and specific complications linked with the use of balloon catheters or caused by the course of the disease, and the character of the valve affection. As the result of analysis of the causes of complications, the authors suggest a system for preparation of patients for operation and the principles of its safe accomplishment and describe the order of the acts undertaken by the surgeon for the management of complications. Analysis of complications of catheter-balloon valvuloplasty demonstrates the efficacy and mild injurious character of this method, which makes it possible to rank it among the generally accepted cardiosurgical methods for the correction of heart valvular stenoses.

[Treatment of complicated forms of mitral valve stenosis by the method of balloon dilatation]. / Lechenie oslozhnennykh form mitral'nogo stenoza metodom ballonnoi dilatatsii.

The degree of the anatomical changes of the valvular apparatus and the severity of the hemodynamic disorders affect the results of radiologically-guided intravascular treatment of mitral stenosis. The complicated forms of mitral stenosis included cases of multivalvular affections (52), calcinosis (61), coarse fibrosis (119), pulmonary hypertension (91), atriomegaly (79), aortic incompetence exceeding I degree (37), and anomalies in patients over 50 years of age (77). The listed conditions were an additional risk factor in performing 221 interventions for percutaneous catheter-balloon valvuloplasty. They call for individual alteration of the techniques of balloon dilatation and dosed manipulation on the valvular structures in accordance with the concrete form of the valvular disease. Such an approach made it possible to reduce the frequency of complications (from 30 to 4.8%) and mortality (from 9.6 to 0.59%).

[Balloon dilatation of aortic coarctation]. / Ballonnaia dilatatsiia koarktatsii aorty.

Endovascular balloon dilatation of coarctation of the aorta is a manipulation for radical correction of the anomaly with an evident hemodynamic effect in patients with the isolated form, in combination of coarctation of the aorta with aortic stenosis, and in atypical forms of the anomaly. Up to 90% of good immediate results were produced among these patients. Balloon dilatation may also be conducted in recoarctation after the traditional surgical management. Being devoid of some of the negative factors of the accepted methods of treatment, endovascular angioplasty is a sparing and a relatively safe method. Paradoxical hypertension does not develop as a rule. Rare complications in the zone of the approach were encountered. Balloon dilatation may be combined with endovascular correction of other anomalies, and may be repeated many times. In recoarctation and atypical forms of the anomaly balloon dilatation helps in avoiding complex and dangerous operations using the traditional methods. Coarctation in the form of a diaphragm is the most "favourable" type of the anomaly for balloon dilatation. The operation is also indicated in coarctation in patients with hypoplasia of the arch and isthmus, despite its palliative character.

[Experience with using balloon dilatation of the coronary arteries]. / Opyt ispol'zovaniia ballonnoi dilatatsii koronarnykh arterii.

The paper presents the analysis of balloon dilations of the coronary arteries in 18 patients with ischemic heart disease. A multimodality clinical examination of the patients involving provocative tests and echocardiography is recommended to be performed both preoperatively and postoperatively.

[Use of original valve devices on a catheter in the correction of aortic valve insufficiency (results of testing unit studies]. / Primenenie original'nykh klapannykh ustroistv na katetere dlia korrektsii nedostatochnosti aortal'nogo klapana (rezul'taty stendovykh ispytanii).

A defective aortic valve removed from a cadaver was installed on a testing unit imitating systemic circulation. The defect (insufficiency of the valve) was corrected by means of valvular devices consisting of a thin elastic membrane which was flat and round in one case and shaped like a spherical vault in the other; the devices were fastened on the distal end of a catheter. The authors present the values of pressure in the heart, aorta and coronary arteries and the minute circulation volume before and after correction of the defect. It is concluded that the suggested valvular devices are efficient and further study is expedient.

[Percutaneous endovascular catheter balloon dilatation of mitral and aortic valve stenosis]. / Chreskozhnaia éndovaskuliarnaia kateternaia ballonnaia dilatatsiia stenozov mitral'nogo i aortal'nogo klapanov.

An endovascular operative technique of monoballoon valvuloplasty of the mitral and aortal valves through a single transseptal access is proposed. The orientation of the dilating balloon in the inlet and outlet portions of the left ventricle, change of the catheter-dilator is controlled due to a loop of the conductor connecting the right and left parts of the heart. This method of endovascular operative treatment was tested in the process of surgical operations in 34 patients with mitral and aortal stenosis. A considerably greater area of the dilated opening was obtained in 30 patients.

[Treatment of stenosis of the aortic orifice by the method of balloon dilatation]. / Lechenie stenoza ust'ia aorty metodom ballonnoi dilatatsii.

Methods for balloon dilatation of stenosis of the aortic orifice through an arterial and venous approaches are suggested. The method was approved in treatment of 51 patients whose ages ranged from 4 to 63 years. Retrograde advancement of the balloon to the constricted part is most rational. In antegrade movement of the balloon there is a hazard of inflicting injury to the structures of the mitral valve (4 cases). Both methods produce a similar therapeutic effect: the area of the orifice increased 4.3 times, the systolic pressure gradient reduced by 3.3 times. II degree aortic insufficiency developed in 2 patients and I degree insufficiency in 3 patients. The method may be an alternative in the treatment of valvar and membranous subvalvular aortic stenosis.

[The effect of antifungal agents on the chemoluminescence of polymorphonuclear leukocytes]. / Vliianie protivogribkovykh agentov na khemoliuminestsentsiiu polimorfno-iadernykh leikotsitov.

The intensity of the formation of active forms of oxygen by Staphylococcus-activated polymorphonuclear leukocytes (PMNL) was registered according to the level of luminol-dependent chemiluminescence. Peritoneal PMNL of rats were shown to be already in an activated state. Activation probably occurred in the process of their penetration into the abdominal cavity. For this reason, further studies of three chloral and griseofulvin derivatives with respect to their influence on the metabolic activity of phagocytes were made on PMNL of human peripheral blood. The compounds under study were found to produce a suppressive effect, which was probably linked with their influence of the enzymatic cell systems taking part on the formation of active forms of oxygen.

[Characteristics of determining microorganism sensitivity to new chemical compounds]. / Nekotorye osobenoosti opredeleniia chuvstvitel'nosti mikroorganizmov k novym khimicheskim soedineniiam.

The main requirements for standardization of the experimental conditions should be observed with a purpose of unification of assays on microbial sensitivity to diverse chemical compounds and increasing the significance and comparability of the results. The choice of the main reference cultures, inoculum, nutrient medium (Hottinger broth, AGV medium) and incubation conditions, as well as recording and interpretation of the results are the most important of them.