[2-stage surgical correction of complex congenital abnormalities of the heart, lung and diaphragm in a child].
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Biomedical subjects
Publications and source records attributed to A A Voronov.
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An analysis of 299 operations on the thoracic part of the esophagus has been made. The authors consider the method of choice to be a one-step operation of the Lewis type in cancer and scarry strictures of the esophagus. Clinical signs of diverticulitis even of a small degree are thought to be indication to diverticulectomy.
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An experience with the surgical treatment of 30 patients has been analyzed. A conclusion is made of the efficiency of correction of the supracardial form of a partial anomalous drainage of the pulmonary veins with the help of septoplasty modified by the authors.
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The authors have shown that among 173 patients with the insufficient closing function of the cardia there were 18 patients with pseudo-coronary syndrome related with reflux-esophagitis. Operations were performed on 14 of them with good effects. The surgical correction of insufficiency of cardia functions in most cases gives elimination of cardio-vascular disorders resulting from reflux-esophagitis.
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Under analysis were the nearest results of resection of the lungs for bronchoectasias in 360 patients aged from 5 to 68. Favorable nearest results were noted in 96.4% of the patients operated upon, with no lethal outcomes. Pleural complications met in 11% of the cases proved to be consequences of inadequate hermetic quality of the pulmonary and bronchial sutures. Remote results from 1 to 10 years were studied in 267 patients. Complete recovery was achieved in 29.9%, considerable improvement in 53.2%, the condition failed to change in 13.8%, aggravation was noted in 3.1%. Best results were obtained after operations performed at the age of 5-10 years, radical treatment in unilateral and bilateral bronchoectasias. Long-term results of the operations were influenced by pleuropulmonary complications, not treated chronical bronchitis, emphysematous alterations in the residual portions of the lungs.
The authors analyse the experience with the surgical treatment of about 3000 patients with different forms of cardiac pathology and general lethality in 4,1% of cases. Favorable results were obtained following operations in children of the first three years of life with the open arterial duct, in 4 to 6-year-old children with coarctation of the aorta. The authors show expediency of correction of septal defects before severe disturbances of hemodynamics could develop. The closed method of correction is indicated in non-complicated forms of mitral stenosis. Patients with complicated forms of mitral stenosis, mitral insufficiency should be operated upon under conditions of artificial blood circulation.
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