Development of a Method for Isolation of Mature Cardiomyocytes from Human Heart Biopsy Specimens.

To increase the yield of living cells and their survival, studies were carried out to optimize the method for isolating cardiomyocytes from biopsy specimens excised from the right atrial appendages. It was found that creatine, blebbistatin, and taurine are necessary components of the buffer solution during cardiomyocyte isolation, and that composition of the solutions is a more important factor than their oxygenation.

[Left ventricle myocardium hypertrophy of donor heart: the results and outlook].

Left ventricular hypertrophy - is one of the most frequent structural changes in the heart. This article is devoted to the assessment of modern views on the causes of myocardial hypertrophy of the donor heart, indications and contraindications for the heart trans­ plantation, the outlook of expanding the pool of effective donors through the use of these hearts. Here are considered the issues of post-transplantation remodeling of the donor heart myocardium, The pathogenesis features, the nascence risk and possibilities of drug regulation of the transplanted heart's myocardial hypertrophy of the left ventricle.

[Surgical repair of secondary tricuspid regurgitation]. / Khirurgicheskaia korrektsiia vtorichnoi nedostatochnosti trikuspidal'nogo klapana.

Optimal surgical strategy for secondary tricuspid regurgitation is still under discussion. First of all, this is due to rare organic disease of tricuspid valve and tricuspid regurgitation is almost always classified as secondary insufficiency. Fibrous annulus enlargement of tricuspid valve is the most common cause of tricuspid regurgitation. Annular dilatation may by the result of left ventricular failure due to myocardial or valvular diseases, right ventricular enlargement, pressure or volume overload. No surgical correction of tricuspid insufficiency during cardiac surgery for other leading disease aggravates short- and long-term results. Considering the wide interest and disputes around optimal surgical strategy for tricuspid regurgitation, this review is devoted to modern methods of surgical treatment of secondary tricuspid insufficiency.

[Auxiliary blood circulation and the artificial heart: forty years of development].

The article summarizes forty-year experience in working over the problem of the artificial heart and auxiliary blood circulation in Laboratory and later Research Institute of Transplantology and Artificial Organs. This work has resulted in the development of balloon pumps for intraaortic contrapulsation, the technique of balloon installation, and indications to its application. The results of the clinical application of the method in patients with various pathologies have been estimated. Preclinically, left ventricular bypass techniques have been tested on more than twenty models of membrane type artificial ventricles. The results of the clinical application of left ventricular bypass have been analyzed. The authors adduce data on the development of the thermomechanical implantable bypass system "Micron-M". After achieving 100-day survival of calves with an artificial heart, an artificial heart with external power supply was used as a "bridge" to heart transplantation, but there was only one patient in whom transplantation was performed. The authors consider development of implantable auxiliary blood circulation devices and the artificial heart to be of great prospective value.

[The plasma level of an inactive moiety of B-type natriuretic peptide precursor as a predictor of cardiac function during operations under extracorporeal circulation].

Ventricular cardiomyocytes secrete brain natriuretuc peptide (BNP) and an inactive moiety of its precursor (nt-proBNP). It is recommended the blood level of the latter should be monitored to ascertain the severity of myocardial lesion. This investigation was undertaken to study the diagnostic and prognostic value of a substantial increase in blood nt-proBNP levels (600 pg/ml or more) in patients operated on under extracorporeal circulation. Thirty-eight patients operated on for coronary heart disease were examined. Before surgery, the plasma concentration of nt-proBNP had been determined by electrochemiluminescence (Elescys, Roche). According to plasma nt-proBNP levels, the patients were divided into 2 groups: 1) 24 patients with nt-proBNP levels of less than 600 pg/ml; 2) 14 patients with its levels of 600 pg/ml or more. Group 1 patients showed signs of diastolic dysfunction of the right ventricle: the lower ratio of its early to atrial filling linear velocity integrals and the increased end-diastolic volume index. In the postperfusion period, nt-proBNP is a significant independent predictor of left ventricular function. The patients with the baseline nt-proBNP levels of above 600 pg/ml were found to have decreases in ejection fraction of the left ventricle and in its pump ratio along with elevated pulmonary wedge pressure.

[Problems of general surgery in clinical transplantology and cardiac surgery].

The authors have analyzed results of operative treatment of 128 patients with terminal chronic renal failure (59) and cardiac pathology (69) associated with general surgical diseases (cholelithiasis, abdominal hernias, ulcer disease, malignant tumors etc). The authors recommend the indications, terms and character of operative measures be defined individually.

[Treatment of patients with general surgical diseases after open-heart operations with cardiopulmonary bypass].

Experience in surgical treatment of 69 patients suffering from coronary heart disease and valve pathology in combination with various general surgical diseases was summarized. Two methods of surgical correction were studied: combined one and staged one. Up-to-date technologies such as endoscopic surgery, tension free hernioplasty, and artificial materials were used during the procedures. Combined procedures reduce the risk of general surgery complications early after surgery. Correction of cardiovascular pathology has a priority in curative algorithm.

[An experimental study of acoustic noise of heart valve prostheses]. / Eksperimental'noe issledovanie akusticheskogo shuma iskusstvennykh klapanov serdtsa.

The paper deals with the acoustic noise that accompanies the work of artificial cardiac valves (ACV). The generation of a noise signal is a substantial disadvantage of ACV work after implantation. A highly sensitive solid-state probe was used to measure the noise signal. The disc ACVs Bjork-Shiley (USA), Omniscience" (Italy), MIKS, a basic (Russia), MIKS with an acoustic gap (Russia), and MIKS-3 were tested. The valves worked under model physiological flow. The disc valves of the MIKS series with an acoustic gap manufactured by ROSINVEST (Russia) were found to have the least noise.