[The efficacy of prevention of postoperative cognitive dysfunction in cardiac surgeries with the use of the cerebrolysin]. / Éffektivnost' profilaktiki posleoperatsionnoi kognitivnoi disfunktsii pri kardiokhirurgicheskikh vmeshatel'stvakh s primeneniem tserebrolizina.

AIM: To assess the efficacy of postoperative cytoprotection with cerebrolysin in cardiac surgeries without using cardiopulmonary bypass and to analyze the changes in the blood circulation in the postoperative period in groups with- and without cerebrolysin preconditioning. MATERIAL AND METHODS: Thirty-eight patients, who underwent coronary and mammaro-coronary bypass grafting without using cardiopulmonary bypass, were included in the study. Fifteen patients received cerebrolysin before surgery. RESULTS AND CONCLUSION: Cerebrolysin improved cognitive test scores. Positive changes on anxiety and depression scales were observed as well. In the group of patients treated with cerebrolysin, quantitative parameters of the cerebral blood flow were in stable condition, with a slight increase on the 10th day after surgery, which may indicate increasing stress resistance of cells of the central nervous system after appropriate pharmacological protection.

BYPASS SURGERY IN PATIENTS WITH COMBINED ATHEROSCLEROTIC LESIONS OF COMMON AND INTERNAL CAROTID ARTERY.

An analysis of data of carotid angiographies was made in 146 patients with chronic cerebrovascular disease. Combined lesions of the common and internal carotid artery with clinical signs were revealed in 2 (1,4%) patients. A crossed extraanatomic bypass from the left common carotid artery to the right internal carotid artery was performed in one patient. The orthotopic common-internal autovenous bypass on the right side was carried out for another patient. According to obtained results, the authors suggested that the orthotopic or extraanatomic common-internal carotid artery bypasses could be applied in case of impossibility of endovascular intervention, when patients had the combined atherosclerotic lesions of common carotid and internal carotid artery.

[Ischemic heart disease and arterial hypertention as risk factors of surgical treatment of patients with infrarenal segment of aortic aneurysm].

A retrospective analysis of the data of 188 patients with the infrarenal segment of the aortic aneurysm (ISAA) showed, that ischemic heart disease and arterial hypertension were diagnosed practically in all patients--175 (93.0%) and 177 (94.1%) patients respectively. A decreased retractor function of the myocardium was noted in 88 (46.8%) of patients. According to the findings of echocardiography 134 (71.3%) patients had the arterial hypertension of third degree. For the assessment of the influence of the accompanying cardiac pathology on the results of planned surgical treatment and systematization of postoperative cardiac complications the classification, which was proposed by R. B. Rutherford et al. and modified by A. V. Pokrovsky et al. was used. The obtained data point at a direct proportional relationship between the degree of the initial cardiac status, frequency and severity of postoperative cardiac complications in patients after resection of ISAA in 1.6-2.3 times.

[Postprandial hypotension in patients with compression of the celiac trunk].

One of the causes of the development of postprandial hypotension is thought to be impaired vegetative nervous regulation of arterial pressure. Patients with the syndrome of the celiac trunk compression also have signs of dysautonomy. The investigation performed has shown that syndrome of the celiac trunk compression is often combined with postprandial hypotension. Patients with such combination much more often have complains associated with asthenia and dysfunction of the autonomous nervous system. After operative treatment of patients with the celiac trunk compression (decompression of the celiac trunk) the frequency of symptoms of postprandial hypotension and clinical manifestations of asthenia and dysautonomy become less often in such patients.

[Biomechanical and flow characteristics of stentless and stented aortic valve bioprostheses]. / Biomechanicheskie i potokovye kharakteristiki beskarkasnykh i karkasnykh bioprotezov aortal'nogo klapana.

A comparative investigation of biomechanical and hydrodynamic characteristics of stentless and stented bioprostheses was carried out. It was demonstrated that stentless bioprostheses are functionally superior to stented ones. The differences between biomechanics and hydrodynamics of the examined stentless bioprostheses "BioLab", "AB-Mono-Kemerovo" and DD2 and stented bioprostheses "Wessex", "KemCor" and "Bionox-2" were shown.

[Effects of implantation technique on hydrodynamic and biomechanical characteristics of stentless aortic valve bioprostheses in experiments]. / Vliianie tekhniki implantatsii na potokovye i biomekhanicheskie kharakteristiki beskarkasnykh bioprotezov aortal'nogo klapana v éksperimente.

A comparative analysis of experiments with biomechanics and hydrodynamic stentless xenografts implanted into the subcoronary position with completely (n = 7) and partially (n = 7) scalloped sinuses was made. The implantation was performed into the human aortic root complexes in vitro. Factors of the influence on biomechanical and hydrodynamic performances of xenografts before and after implantation have been established. Subcoronary implantation of stentless bioprostheses with the completely scalloped sinuses proved to result in better flow and biomechanical characteristics than the implantation technique with the saved noncoronary sinus.

[Age-dependent dynamics of biomechanical and hydrodynamic properties of the valve-aortic complex of man]. / Vozrastnaia dinamika biomekhanicheskikh i gidrodinamicheskikh svoistv klapanno-aortal'nogo kompleksa cheloveka.

A comparative analysis of geometrical, biomechanical and hydrodynamic characteristics of the valve-aortic complexes taken from humans of different age has shown a determining role of distensibility of the aortic root in the functioning of valve cusps. An alteration of geometrical relationships of elements of the aortic root, its less distensibility, worse biomechanical and hydrodynamic characteristics of the aortic valve in humans older than 50-60 years of age is established.