[Results of transcatheter closure of the secundum atrial septal defects in children].

Immediate and long-term results of transcatheter closure of defects of interatrial septum (DIAS) with occluder Amplatzer were analyzed. An attempt of transcatheter closure of DIAS was undertaken in 62 children aged from 2 through 17 years (mean age 10.93 +/- 4.57 years), among them there were 19 boys (30%) and 43 girls (70%). Successful implantation of the occluder was fulfilled in 60 patients, but in 2 patients there were failures. Complete occlusion of DIAS by the data of transthoracic echocardiography (TTE) fulfilled immediately after implantation of the occluder was noted in 57 patients (92%), 3 patients had insignificant (1) and small (2) residual flow, in 2 patients--directly through occluder and in 1--along the lower border of the occluder. TTE with Doppler mapping made 24 hour after the procedure has demonstrating the absence of residual flow in 59 patients (98%), including 2 patients out of 3 with a residual shunt immediately after implantation of the occluder. In 1 child there was a negligible shunt left along the lower border of the occluder which disappeared within a month in control TTE. Complications during performing transcatheter closure with DIAS occluder Amplatzer appeared in 3 patients. In 2 patients there was arrhythmia, in 3 patients during implantation of the occluder with diameter 34 mm the right atrial auricle was damaged that required sternotomy and suturing the auricle wound. Long term results were followed up in 40 patients during 1-3 years. None of the patients had residual shunts or erosions of the atrium walls or aorta, or disturbed heart rate.

[Failures and complications of transcatheter coil occlusion of patent ductus arteriosus]. / Neudachi i oslozhneniia chreskateternoi spiral'noi okkliuzii otkrytykh arterial'nykh protokov.

An analysis of fails and complications of transcatheter coil occlusion of patent ductus arteriosus (PDA) was made. An attempt to close PDA with Gianturco coils was undertaken in 132 patients. Fails were noted in 4 (3.1%) children, 3 of them failed to hold the coil in PDA due to its greater width, and in 1 patient the catheter could not be delivered through a narrow duct. Complications were noted in 9 patients (7%): migration of the coils into the pulmonary artery branches took place in 8 patients, and in 1 patient there appeared haemolysis due to a large residual shunt. Snare-assisted removal of the migrating coils was carried out in 7 children, in 1 girl the coil could not be extracted from the peripheral branch of the left pulmonary artery. In 7 patients reocclusion of PDA was made, in 1 case no reembolization was performed. Haemolysis was liquidated by an additional implantation of the coils in repeated procedure. Risk of fail and complications was associated with great minimal diameter of patent ductus arteriosus.

[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.

[Development of clinical physiology in heart surgery]. / Razvitie klinicheskoi fiziologii v kardiokhirurgii.

The article deals with the analysis of the monograph Evaluation of Performance and Analysis of Cyclic Work of the Heart written by B. A. Konstantinov, V. A. Sandrikov, and V. F. Yakovlev. It discusses the possible mechanism of the maintenance of the stability of hemodynamic indices--switching into action the contractions of nonfunctioning cardiomyocytes (the factor of functional heterogeneity).