False Aneurysm of the Proximal Sano Shunt in a Patient With Hypoplastic Left Heart Syndrome After Bidirectional Superior Cavopulmonary Connection.

The case describes the surgical treatment of a patient with a false aneurysm of the proximal anastomosis of the Sano shunt in a patient with hypoplastic left heart syndrome midterm after bidirectional cavo-pulmonary anastomosis. The diagnostic algorithm included a physical examination, echocardiography, and multispiral computed tomography. Surgical treatment included closure of the right ventricular defect and removal of blood clots from the cavity of the false aneurysm.

[Surgical treatment of infective endocarditis of the right sections of the heart]. / Khirurgicheskoe lechenie infektsionnogo éndokardita pravykh otdelov serdtsa.

The authors present results of surgical treatment of infective endocarditis of the right chambers of the heart in 22 patients subjected to 23 operations. Primary endocarditis was diagnosed in 14 patients, secondary endocarditis in 8 patients. Four patients died. In 12 patients the operations were performed during the active phase of the process. Positive bacterial hemoculture was detected in 11 patients. The operations were performed on the open heart. For correction of valve lesions artificial heart valves were used either with special antimicrobial cuffs ("Silzone") or cuffs impregnated with silver ions ("St. Inda Med.") or treated with a solution of Rifampicin during operation.

[Initial experience with the surgical treatment of hypertrophic cardiopathy using an apico-aortic valved conduit]. / Pervyi opyt khirurgicheskogo lecheniia gipertroficheskoi kardiopatii s ispol'zovaniem klapansoderzhashchego apiko-aortal'nogo konduita.

Long-term results (up to 3 years) of operative treatment of first patients with complex obstruction of the left ventricle outflow tract (hypertrophic cardiomyopathy--10 patients, congenital subaortic tunnel stenosis--1 patient) with the help of apico-aortic valved conduit are presented. There was no intrahospital lethality. Two patients died in late terms after operation who had been operated upon for the III degree of circulation insufficiency. Complications associated with using the valved conduit were not noted. All the patients operated upon did not need medicamentous therapy (indirect anticoagulants excluded), seven of them had the 1st functional class NYHA by the moment of examination, two had the 2nd functional class. Continuous observations have revealed a marked tendency to normalization of the hemo- and cardiodynamic parameters.

[A new method for the plastic repair of the aorta in coarctation]. / Novyi sposob plastiki aorty pri ee koarktatsii.

Thirty-six patients underwent operation in the Samara Cardiosurgical Centre in the period from 1987 to 1991. Their ages ranged from 18 months to 28 years, 32 of them were under 16 years of age. The operation was carried out through a lateral approach in third or fourth intercostal space. After mobilization of the aorta the constricted part was resected together with the orifice of the ductus arteriosus at a distance of 2-3 mm from the constricting membrane without removal of areas of conic constrictions of the remaining ends of the vessels. Longitudinal incisions were made in the aortic walls perpendicular to one another and the edges of the flaps were shaped to form triangles. An anastomosis was then formed with continuous sutures. The average time of compression of the aorta was 27 +/- 2.5 min. There were no fatal outcomes. Among the complications were bleeding which called for rethoracotomy in 2 patients, and suppuration of the wound in 3 patients. Thirty-two persons were discharged from the clinic with normal arterial pressure, in 4 patients the pressure reduced as compared to the preoperative level. The long-term results were studied in 29 patients in follow-up periods of 6 months to 4 years. Twenty-five of them had no complaints, residual hypertension was encountered in 4 patients but without signs of recoarctation. Thus, with the use of the described method the possibility for forming a direct anastomosis in cases in which a prosthesis had to be formed applied is greater, and in operations on children it became possible to increase the lumen of the anastomosis with growth of a child.