[Progress in cardiovascular surgery: new analytical, experimental, and technological approaches].

Blood flow in heart and main vessels is a self-organizing eddy flow described by Kiknadze-Krasnov's non-stationary hydrodynamic equations. Their exact solutions are applicable to simulation of blood circulation in normal and pathological conditions, quantitative evaluation of efficiency of surgical treatment of cardiovascular diseases, and designing implantable devices for cardiovascular surgery to support physiological blood flow structure. An essentially new all-flow three-leaflet CorBit artificial heart valve from pyrolyitic carbon has been proposed to maintain physiological blood flow with minimal regurgitation and transvalvular pressure gradient. The CorBit valve allows to normalize hemodynamic parameters soon after implantation. Also, manufacture is underway of a wide range of original stented and stentless bioprostheses of heart valves and valve-containing BioLab conduits from allogenic and xenogenic biological tissues. BioLab bioprostheses are currently widely used to treat complicated congenital and acquired forms of cardiopathology.

[Cryopreserved allo-grafts in aortic valve surgery].

Bakulev Scientific Center for Cardiovascular Surgery resumed research into cryopreservation and creation of valve bank in 1990. This technology allowed preparation of valve allo-grafts with preserved cell reproductive capacity for clinical use. A new technology, allowing reduction of calcinosis in the graft's aortic wall, was developed and experimentally tested in 2003. 61 aortic valve replacements with cryopreserved allo-grafts were performed between 1992 and 2003. The three techniques of implantation included: subcoronary (38), intraaortic cylinder (8) and "free-standing root" (15). 44 patients developed active infective or prosthetic endocarditis. Hospital mortality rate was 11.5%, 12-year survival rate--90%. Dysfunctions and reoperations were significantly rarer in cases of inclusion cylinder and free standing root. The authors conclude that cryopreserved allo-grafts allow good quality of life without use of anticoagulants and low rate of reinfection. The use of subcoronary technique for implantation must be limited and method of choice should be free-standing root, especially in cases of destructive infective or prosthetic endocarditis. Cellular engineering probably will elongate the stability of long-term results.

[Clinical appliance of new biologic glue "Biokley-LAB" in cardiac surgery with artificial circulation]. / Klinicheskoe primenenie novogo biologicheskogo kleia "Bioklei-LAB" pri operatsiiakh na serdtse v usloviiakh iskustvennogo krovoobrashcheniia.

Data on clinical appliance of domestically produced two-component gelatin-resorcin glue "Biokley-LAB" in difficult surgeries on the ascending aorta and aortal valve with artificial circulation demonstrate that this glue is good prophylactic haemostatic remedy which reduces risk of postoperative bleedings.

[Physical-mechanical and functional characteristics of xenograft during various methods of stabilization and treatment]. / Fiziko-mekhanicheskie i funktsional'nye kharakteristiki ksenotkani pri razlichnykh vidakh stabilizatsii i obrabotki.

The paper gives the results of experimental studies of the elastic-strength and functional characteristics of xenotissue samples (the pericardium of the calf, pig and Glisson's capsule) stabilized with glutaric aldehyde and polyepoxy compounds. The paper discusses various treatments of biological materials (including Glisson's capsule) anticalcified with additives (sodium dodecyl sulfate, complexes of copper and zinc) and shows that their use improves proteolytic and calcinotic resistance without deteriorating the mechanical parameters of xenotissues. Comparative analysis of the physical-mechanic and functional characteristics of xenotissues treated in different ways allows one to make anticalcifying treatment of biological tissues with copper and zinc complexes physical-mechanic and functional characteristics of xenotissues (Glisson's capsule) for clinical application.

[The effect of droperidol on heart function]. / Vliianie droperidola na funktsiiu serdtsa.

The effect of droperidol (3.3 x 10(-6) M) on the functional capacities of the isolated heart has been studied. The drug inhibited myocardial contractility. The effect manifested directly after the introduction of droperidol into perfusate (prompt phase). Afterwards the progress of the drug inhibitory effect was slow (slow phase). It is assumed that the difficulties in the use of droperidol in the critical cardiosurgical patients are associated with the attenuation in the realization of the regulatory effects of the central nervous system.

A comparison of the protective effect of a modified StTH solution and HTK-B on the energy and functional status of the isolated rat heart.

Using a model of the isolated beating rat heart, the authors compared the protective effect of St. Thomas Hospital cardioplegic solution enriched with glucose and mannitol (StTH-M) and Bretschneider solution (HTK-B). Results showed that, during 120-minute global ischaemia in cardioplegia, StTH-M was able to maintain levels of high-energy phosphates comparable with those found in a group of hearts perfused with HTK-B at 20 degrees C only when the temperature had been decreased to 12-15 degrees C. Under these conditions, repair of metabolic and functional parameters during post-ischaemic perfusion was also similar in both groups.

[Effect of hypothermia on the metabolism and post-ischemia restoration of myocardial function]. / Vliianie gipotermii na metabolizm i postishemicheskoe vosstanovlenie funktsii miokarda.

Our studies have revealed a prognostically poor course in postinfarction angina pectoris patients on conservative medicamentous treatment. The mortality rate within the first year of this syndrome onset was 19.8 per cent among conservatively treated patients. Surgical management of these patients had a significantly better prognosis. Despite the fact that there was a great difference in survival rates between the studied groups at the hospital stage, the survival rate was significantly higher at subsequent stages in surgical patients compared to that in the conservatively treated group, and correlated with that in a larger population of matched age. In addition, surgical treatment was found to substantially improve the quality of life in patients with postinfarction angina pectoris which implies lowered frequency of attacks, increased exercise tolerance, and improved working capacity.

[Ion currents in mitochondrial and liposome membranes induced by acid action]. / Ionnye potoki v membranakh mitokhoncrii i liposom, indutsirovannye deistviem kislot.

It is shown that potassium ion yield from mitochondria observed under low pH of the incubation medium and at the addition of n-(N,N-di-2-Chloridethyl)aminophenylacidic acid and low concentrations of 2,4-dinitrophenol results from the formation of non-electrogenic (nigericyn-like) carrier. The data are obtained which show that under experimental conditions a weak electrogenic transport of ions is observed along with non-electrogenic ion transport in the membranes.

[Suppression of humoral antibody synthesis on exposure to hyperbaric oxygenation]. / Podavlenie sinteza gumoral'nykh antitel pod deistviem giperbaricheskoi oksigenatsii.

The influence of hyperbaric oxygenation (HBO) on the immune response in mice, immunized intraperitoneally with sheep red blood cells, was studied. HBO was shown to reduce hemagglutinin and hemolysin titres in peripheral blood as well as to decrease the amount of antibody-forming cells in the spleen. The most pronounced immunodepressant HBO effect is seen when hyperbaric oxygenation is carried out under toxic conditions before immunization of the animals with low antigen doses. Relationship is shown between the immunodepressant HBO effect and reduced leucocyte and lymphocyte counts in peripheral blood of the animals.

[Induction of ion transport coupled to oxidative reactions in the membranes of mitochondria and liposomes]. / Induktsiia ionnogo transporta, sopriazhennaia s okislitel'nymi reaktsiiami v membranakh mitokhondrii i liposom.

The mechanism of induction of potassium permeability for mitochondrial membranes under special conditions was under study. Conditions were such as: 1--incubation of mitochondria in medium with low meaning of pH (6,0--6,5), 2--incubation in preseace of electrophylic agent--p-(N,N-di-2-chloroethyl) aminophenylacetic acid, which is hydrolized to HCl and 3-lipidsoluble acid, 2,4-dinitrophenol. It is shown that the named mechanism in any case requires the oxidation of lipids of mitochondrial membranes.