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Biomedical subjects

A A Beliaev

Publications and source records attributed to A A Beliaev.

At least 19 recordsLinked to original sources

[Minimally invasive coronary artery bypass surgery].

From 19.06.97 to 06.01.2000 36 patients with coronary heart disease underwent direct myocardium revascularization surgery by minimally invasive method (through minithoracotomy, off-pump and on the beating heart), anastomosis between left internal mammaria artery and anterior descending artery (ADA). The majority of the patients (55.6%) had one-vessel damage of ADA coronary bed, in the patients with damage of two and more vessels full revascularization of coronary bed was achieved by two coronary arteries bypass at once or by combination of minimally invasive coronary bypass (MICB) with PTCA. MICB is performed in specially selected patients according to stuct indications. Technique of operation, early postoperative course, possibilities of combination of MICB with other methods of treatment is described. Potential of MICB is discussed.

Coronary Angiography↗

[Prospects for surgical and combined methods for treating acute coronary syndrome].

From 1997 to 2000 diagnostic coronaroangiography was performed in 334 patients with acute coronary syndrome (ACS) which is the group of diseases with common pathophysiological mechanism, namely coronary artery thrombosis. ACS needs revascularization of the affected artery as quickly as possible. 26.6% patients underwent balloon angioplasty (BAP). 14.9% patients underwent emergency and urgent coronary artery bypasses with cold and pharmacological cardioplegia. Minimally invasive coronary bypass (MICB) was used in 4.2% patients. Combined BAP + MICB were performed in 2.1% patients. Indications, terms, sequence and future of ACS surgical treatment are discussed.

Angioplasty, Balloon↗

[Analysis of mental functions in patients after coronary bypass surgery].

The neuropsychological examination was carried out in 18 men (study group), mean age 59.7 +/- 6.6 years, before and after aorto-coronary bypass. The neuropsychological tests were carried out 2-3 days before operation and 14-16 days after it. 12 non-operated men with coronary artery disease, mean age 60.0 +/- 6.7 years, were studied as a control group. In control group the neuropsychological tests were conducted with a 16-19 day interval. The tests examined short-term verbal and visual memory, semantic memory. At statistical analysis of the results the mean values and confidential intervals were calculated allowing for Student's coefficient. In control group at consecutive tests the negative dynamics of the results was not revealed. The comparison of the tests results in the study group patients before and after operation revealed the a decrease of neuropsychological parameters by 20-40% on the average irrespective of material modality. Features of cognitive changes revealed in early postoperative period, testifies to diencephalic type of the disorders.

Cognition Disorders↗

[Gastric bezoars and their complications].

The article discusses four patients who underwent operation for bezoars of the stomach at the Sklifosovsky Scientific Research Institute in a thirty-year period, which testifies to the rarity of the disease. The clinical picture, diagnosis, and the complications of the disease are considered. Special attention is drawn to the surgeon's tactics and the need to inspect the intestine during the operation.

Bezoars↗

[Spinal anesthesia].

The article deals with some aspects of spinal anesthesia. It analyses in the light of possible complications the results of spinal anesthesia conducted in 4,186 cases with 1% sovcaine (cinchocaine hydrochloride) solution and 5% novocaine (procaine hydrochloride) solution by 60 surgeons. Spinal anesthesia was applied in patients, whose ages ranged from 11 to 96 years, in various operations. Contraindications for the method were determined. The author appraises comparatively spinal anesthesia with the related peridural anesthesia and discusses the prospects of the development of the method with the existence of new anesthetics and very thin needles for puncture of the subarachnoid space, which leads to the minimum number of possible complications.

Adolescent↗

[The potentials for hyperbaric oxygenation in the combined treatment of the victims of explosive mine wounds to the extremities].

Hyperbaric oxygenation was used in the combined post-operative treatment of 63 victims with distal segments of lower extremities torn off or damaged by mine and burst effect. The patients consecutively received medicamentous therapy, which improved tissue microcirculation (rheopolyglucinum, haemodesum), surgical intervention, course of hyperbaric oxygenation, and after it anticoagulant preparations (heparinum) were used. The article shows that the combined application of hyperbaric oxygenation and medicinal preparation, that improve microcirculation in traumatized tissues, has a pathogenetic approvement.

Adult↗

[Transesophageal echocardiography in the diagnosis of perioperative ischemia and myocardial infarct].

In 50 patients undergoing direct revascularization of the myocardium, an attempt was made to carry out transesophageal echocardiography. In 5 of them, visualization of the myocardium appeared unsatisfactory, 2 patients were excluded from the investigation in view of the fact that they were operated on in the acute phase of myocardial infarction. Among 43 patients who were entered into the investigation, the areas of abnormal local contractility of the myocardium (AILC) occurred during surgery in 14 (33%). In 3 patients, the newly occurring disorders of local contractility of the myocardium persisted till the end of the operation. In the remaining cases, the presence of the AILC was temporary. The sensitivity of the newly occurring stable AILC in the diagnosis of perioperative myocardial infarction and acute coronary death amounted to 75%, specificity was 100%.

Adult↗

[Laser angioplasty of peripheral arteries].

The first experience in laser angioplasty of the superficial femoral artery in 5 patients is discussed. Local occlusion or critical stenosis (90% and more) of the vessel with signs of disturbed blood supply to the limb were the indications for the intervention. For conducting laser angioplasty the authors used an AIG-neodymium laser (1.06 microns) and a light guide of their own design which allowed a canal of no less than 3.1-3.9 mm in diameter to be formed in the plaque. Patency of the artery was restored in all 5 cases and a satisfactory clinical effect was produced. Thrombosis of the recanalized segment occurred on the 12th day after angioplasty in one case. The prospects of the method and the means of further studies are discussed.

Angioplasty, Balloon↗

[Thrombogenic properties of the inner vascular surface following laser exposure].

Laser angioplasty, using YAG-neodymium laser and a balloon catheter with monofiber quartz light guide (400 micron), introduced into its central canal, was performed in 8 dogs with thromboses of 11 femoral or carotid arteries. Average energy expenditure for recanalization was 26 +/- 4 J, with 4.9 +/- 0.3 W and exposure time of 5.1 +/- 0.7 s. Re-thrombosis developed after 5 to 10 days in all arteries, left in the circulation network after laser angioplasty. The latter part of the study is dealing with the assessment of the surface of femoral or carotid arteries of the dogs after laser exposure. This was done by quantitation of the adhered platelets after platelet-enriched plasma was circulated through vessels, whose inner surface was 1) intact, 2) de-endothelized, or 3) laser-damaged, using a scanning electron microscope. The thrombogenic index was 65-96, 85 and 66%, respectively, for the YAG-neodymium, argon and eximeric (XeCl) lasers.

Animals↗