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Biomedical subjects

A N Kaĭdash

Publications and source records attributed to A N Kaĭdash.

At least 19 recordsLinked to original sources
PubMed2000

[Opportunity of operative traumatism decrease in patients with complicated tricuspid valve defect].

This study examined the results of surgical trivalve of 44 patients with trivalve heart defect. In all the patients the heart defect was combined with two and more complicating factors: advanced III-degree calcinosis of the valves, cardiomegaly, cardiac fibrillation, left atrium thrombosis, high pulmonary hypertension. In 20 patients the operative intervention on the heart was repeated. The analysis of the results allowed to recommend some surgical techniques which allowed to decrease surgical traumatism in patients with complicated trivalve heart defect. Low traumatism was possible because of incomplete removal of the calcium masses extending on the fibrotic ring and outside, use of two-row counter U-suture on linings for the prosthesis fixing, transdoubleatrial approach without isolation of the heart from the adhesions in dense pericardial obliteration, correction even insignificant trivalve heart defect or relative valve incompetence.

Adult↗
PubMed1991

[Catheter-balloon valvuloplasty in mitral valve stenosis (selection of the method of procedure, immediate results and the criteria of patient selection].

Catheter-balloon valvuloplasty (CBV) was carried out in 80 patients with rheumatic mitral stenosis, whose ages ranged from 22 to 68 years. Seventeen of these patients were operated on for mitral valve restenosis; I-II degree calcinosis of the mitral valve was revealed in 18 patients; seven women underwent surgery in the 24th-32nd week of pregnancy. After applying various methods (19 cases) the authors used in the last series of operations (61 cases) the Silin-Sukhov method using an original dilatation catheter with a balloon measuring in diameter up to 34 mm, which allowed pressure of up to 8 atm. to be produced during a working cycle no longer than 8 sec. As the result of CBV, the area of the mitral orifice was enlarged by no less than twice in all patients, the pressure gradient through the mitral valve and systolic pressure in the pulmonary artery reduced. The total number of complications which called for operative treatment was 3.75%. CBV is a still developing method, but already today it may be considered the method of choice in the treatment of uncomplicated forms of mitral stenosis, in I-II degree calcinosis, and when the risk of the traditional surgical intervention on the heart is increased.

Adult↗
PubMed1991

[A method of removing air from the cavities of the heart and great vessels during surgery with extracorporeal circulation].

A strictly successive method for removing air from the heart cavities and great vessels after the intracardiac stage of the operation was elaborated from study of the experience of foreign heart surgeons and experience in the use of various measures for the control of air embolism at the Vishnevsky Institute of Surgery, AMS USSR. The techniques of puncture of the heart cavities and vessels and their massage for complete evacuation of the air is described. These manipulations are combined with thorough decompression of the atria and ventricles to relieve the load suffered by them after cardioplegia. The author applied the described method in 647 patients who underwent operation for congenital, rheumatic, and other heart diseases. Signs of air embolism were not revealed in the postoperative period in these patients.

Cardiac Surgical Procedures↗
PubMed1990

[Use of therapeutic plasmapheresis in heart surgery patients with hepatic insufficiency].

Therapeutic plasmapheresis is a highly effective method in the preparation of patients with hepatic insufficiency for operation on the heart under conditions of extracorporeal circulation. It leads to reduction of the bilirubin level and normalization of the main values of hepatic function. The positive effect of therapeutic plasmapheresis is less manifest in acute hepatorenal insufficiency developing after operation with extracorporeal circulation. The best effect of therapeutic plasmapheresis in the postoperative period was produced in patients in whom hemorrhages and the low cardiac output syndrome were removed.

Acute Disease↗
PubMed1985

[Diagnosis of aortic valve calcinosis with a view to the surgical treatment of aortic valve disease].

Combined roentgenologic/echocardiographic diagnosis of aortic valve calcinosis was made in 135 patients operated on for a rheumatic aortic heart disease. Four degrees of aortic valve calcinosis were identified: 1) isolated fine points of calcinosis, as revealed by echolocation and specific treatment of the removed valves; 2) small-focal calcinosis as revealed roentgenologically in 79.2% of cases and by echolocation, in 93%; 3) large-focal, and 4) wide-spread calcinosis, the latter two being detectable both roentgenologically and echocardiographically in all cases. The 4-degree classification of aortic valvular lesions allows a detailed assessment of the nature of the affection that is important for the choice of surgical procedure.

Aortic Valve↗
PubMed1982

[Relationship between the oscillatory contractions and myocardial tonus in patients with heart defects].

Interplay between contraction oscillations and the tone that is seen during rhythmic stimulation was studied in atrial trabeculae of patients with heart diseases. It was disclosed that in 50% of myocardial preparations from patients with rheumatic heart diseases, an increase in the tone (incomplete relaxation) and oscillations appeared at a frequency of 0.2 HZ. As the frequency was raised, the amplitude of the oscillations and the tone increased. Meanwhile in 25% of the preparations the appearance of the oscillations was not followed by the tone rise. In the remaining preparations, the tone and oscillations were not recorded. No growth of the tone or oscillations was commonly seen in the myocardium of patients with congenital heart diseases. Appearance of low-amplitude oscillations in some of the myocardial preparations from this group of patients occurred at a frequency of 1-2 HZ and was not accompanied by the tone rise. Catecholamines (noradrenaline, izadrin, dopamine) increased the amplitude of evoked contractions but did not change or even reduced the amplitude of oscillations. It is assumed that catecholamines effects are determined by concurrent enhancement of the ingoing Ca current and sequestration of Ca ions by the sarcoplasmic reticulum (as a result of the adenylate cyclase-cAMP system activation). Strophanthine suppresses the Na-K pump and leads to the accumulation by the myoplasma of Na ions which are exchanged for external Ca. As a result, the Ca concentration in the myoplasma and sarcoplasmic reticulum increases. The ability of the sarcoplasmic reticulum to effective Ca sequestration from the myoplasma correspondingly falls.

Cardiotonic Agents↗
PubMed1981

[Mechanical oscillations in the pathologically altered myocardium].

In pathologically altered myocardium (auricles) of patients with acquired heart diseases, there have been found mechanical oscillations of the tone which occurred after basic contracture induced by electrical stimulation. The oscillations were recorded at a normal ionic composition of Tyrode solution and a temperature of 32-34 degrees C. No mechanical oscillations were normally observed in the myocardium of patients with congenital heart diseases. It was shown that oscillations might affect the time course of the frequency-power curves.

Biomechanical Phenomena↗
PubMed1981

[Effect of cooling on rhythmo-inotropic relations in pathologically altered myocardium].

Fragments of the right atrium auricle from patients with congenital and acquired heart diseases were used to study the effect of the Tyrode solution temperature over the 60-minute cessation of electrical stimulation of the preparations on the recovery of the amplitude of rhythmic contractions after the pause. The lack of stimulation within 34 to 24 degrees C does not lower the contraction amplitude after warming of the preparations and renewal of rhythmic stimulation. The hypothermal pause at a temperature of 10-14 degrees C leads to the development of contractures and suppresses the myocardial contractility. The positive inotropic action of dopamin (1.10(-6) g/ml), isadrin (1.10(-7) g/ml) and strophanthine (1.10(-6) g/ml) on the myocardium in patients with acquired heart diseases is remarkably diminished after the hypothermal pause.

Cold Temperature↗
PubMed1979

[Changes in the contractile function of the myocardium in various methods of excluding the heart from the circulation during the surgical correction of acquired heart defects].

Changes in myocardial contractile function were studied during 46 operations with extracorporeal circulation on patients with acquired heart diseases; the operations were performed with the use of cold cardioplegia and electrical fibrillation of the heart. The dependence of the decrease in myocardial contractilicy on the method of cardioplegia, the duration of the heart arrest, and the parameters of extracorporeal circulation is analysed. The results obtained are evidence that it is necessary to improve the method for protecting the myocardium during operations with extracorpeal circulation.

Cardiography, Impedance↗
PubMed1976

[Diagnosis of thrombosis of the left atrium in rheumatic heart defects, using the main components methods].

A new method of diagnosis of left atrial thrombosis was developed for rheumatic heart disease patients. The mathematic method of the main components was used that permits to detect the thrombosis of the left atrium in 94.3% of the cases. Fourteen most frequently encountered symptoms of this complication were singled out, the probability of the occurrence of these symptoms was calculated for the patients with rheumatic heart diseases and atrial fibrillation with and without thrombosis. A computer was employed to develop the method, while no computer is needed for the diagnosis itself. Symptoms from the list must be identified in the given patient, the digital values of the main components found in the table be summed up with that of the free member, with due regard of the sign, and the presence of the thrombus be determined on the basis of the presented chart.

Atrial Fibrillation↗