PubMed Health⌕ Search

Biomedical subjects

G I Tsukerman

Publications and source records attributed to G I Tsukerman.

At least 19 recordsLinked to original sources
PubMed1998

[The surgical treatment of heart defects in active infectious endocarditis].

AIM: To elucidate significance of early diagnosis and results of surgical treatment of valvular defects in active infectious endocarditis (AIE). MATERIALS AND METHODS: Surgical outcomes were analyzed for 437 AIE patients with active AIE. The operation was made 10 months, on the average, after AIE onset. RESULTS: Total hospital lethality made up 11.2%. Total 5-year survival with account for hospital death was 77-80% in replacement of one valve and 61.6% in replacement of two valves (mitral and aortic). In natural course of the disease it was 16%. CONCLUSION: There was a direct relationship between hospital lethality and admission condition of the patients, advance of the inflammation. This urges early AIE detection and performance of operation before development of irreversible changes in the myocardium and other organs.

Endocarditis, Bacterial↗
PubMed1996

[The surgical treatment of multiple myomas of the left heart].

5 patients with multiple left heart myxomas have been followed for 30 years. There were 4 females and 1 male at the age of 20-50 years. Two-dimensional echocardiography was used for the proper diagnosis in all cases. Open-heart surgery is the only possible method of treatment in such a situation. All the patients have been successfully operated on. To prevent the recurrence the resection of myxomas with a part of interatrial septum and endocardium was performed. The trans-sternal approach is the optimal one for the surgery of myxomas.

Adolescent↗
PubMed1992

[Active valvular infective endocarditis: problems of surgical treatment].

The authors analyze the results of surgical treatment of patients suffering from active endocarditis with impairment of the mitral, aortal and tricuspid valves and their combinations in 242 patients operated on during 1969 to 1989. The total hospital mortality is at the level of world statistics and constitutes 15.3% (37 patients died). The main cause of the hospital mortality was acute progressive heart failure (48.6%). The long-term results of the surgery were examined in 202 patients. By the 5th observation year the total survival was 73.2%, the stability of good results 83.6%. The defined grades of the activity of infectious process play an important role in the diagnosis and treatment of patients with active valvular infectious endocarditis.

Adolescent↗
PubMed1992

[Clinical aspects, diagnosis and surgical treatment of rupture of the mitral valve chordae].

The authors generalize experience in surgical treatment of 121 patients with mitral incompetence caused by rupture of the chordal threads. Prosthetics of the mitral valve was conducted in 103 patients, plastic correction--in 18 patients. Study of the etiomorphological aspects of the problem showed destruction of the fibrous framework of the chorda to be a compulsory component of rupture of the chordae of various origin. At the same time, there are some similar clinico-diagnostic manifestations of rupture of the chordae, which allows this form of mitral valvular disease to be set apart as an independent syndrome. Echocardiographic study is the most informative method in the diagnosis of the disease, it reveals rupture of the chordae in over 95% of cases. The immediate and late-term results of plastic operations and prosthetics were compared. Plastic operations are preferable in a favorable situation because survival after them is higher and thromboembolism does not develop even if anticoagulant therapy is not applied.

Adolescent↗
PubMed1991

[Heart valve bioprostheses of the "Bionix" series. 6-year experience with the mitral valve replacement].

The main cause of cardiac valve bioprosthesis dysfunction is mechanical rupture of the cusps consequent upon the development of "fatigue" tensions and calcification of the biologic tissue. The technology of "Bionix" prostheses manufacturing implies prevention of these complications by means of supporting frameworks of variable rigidity (dumping stroke loads) and the use of a calcinosis inhibitor in the process of chemical stabilization. Experimental research confirms the certain effectiveness of such an approach to solving the problem of bioprosthesis durability. Experience in clinical application of biological valves of this series showed that by the 5th postoperative year the stability of good results was 90.0 +/- 2.2%; absence of thromboembolic complications in 93.3 +/- 2.4%, and no need to operate because of dysfunction of the bioprosthesis in 96.6 +/- 2.1%.

Adult↗
PubMed1991

[Experience in the use of Soviet-made disk prostheses EMIKS and LIKS].

Experience in the application of and disc prostheses in 614 patients in generalized. Mitral prosthetics was conducted in 256, aortic in 229, and mitral++-aortic in 129 patients. Hospital lethality was, respectively, 3.9, 4.8, and 8.5%. In postoperative follow-up periods of up to 7 years 92.1% of patients were examined. Survival was 88.1 +/- 0.71% in the mitral, 87.0 +/- 0.62% in the aortic, and 80.2 +/- 0.84% in the mitral-aortic group. No thromboembolic complications occurred in 88.7 +/- 0.64%, 96.9 +/- 0.31%, and 88.3 +/- 0.68% of patients, respectively. In the mitral position the mid-diastolic gradient was 4.0 +/- 0.31 mm Hg on the prosthesis and 3.8 +/- 0.82 mm Hg on the prosthesis; in the aortic position the peak systolic gradient was, respectively, 23.2 +/- 0.58 and 22.4 +/- 0.7 mm Hg. At the time of examination 97% of patients belonged to I and II functional classes.

Aortic Valve↗
PubMed1991

[Reoperations in patients with EMIKS and LIKS prostheses].

The frequency, terms, techniques, and the results of reoperations on patients with EMIKS and LIKS prostheses are analysed. In the period between June, 1983 and December, 1989, 994 EMIKS prostheses and 210 LIKS prostheses were implanted in 1,015 patients. In this period 22 reoperations were performed which accounted for 0.62% of patients per year. The reasons for the repeated operations were prosthetic endocarditis in 54.5%, paraprosthetic fistula in 36.4%, and wedging of the disk of a mitral prosthesis in 9.1% of patients. In 81.8% of patients the second operation was conducted within the first year after the first operation. By the 6th postoperative year 96.4 +/- 0.61% of patients did not need a reoperation. This index was 97.1 +/- 0.54% in the group of patients with isolated mitral prosthetics, 95.7 +/- 0.88% in aortic prosthetics, and 94.9 +/- 0.91% in mitro-aortic replacement. Hospital mortality in the group of patients with reoperations was 22.7%.

Heart Valve Prosthesis↗
PubMed1990

[Unsolved problems of the surgical treatment of dissecting aneurysms of the ascending aorta (analysis of complications)].

It is shown that various complications occurring after surgical treatment of dissecting aneurysms of the ascending aorta with or without aortic insufficiency depend mainly on the methods of correction applied and the etiology of the disease. As the result of the study the authors conclude that the Bentall-De Bono and Cabroe's operations are radical methods for surgical management of dissecting aneurysms of the ascending aorta irrespective of the etiology of the disease. Wide introduction of these operative methods into the clinical practice led to an essential decrease of hospital mortality and the frequency of complications in the immediate and late-term postoperative period.

Adult↗
PubMed1990

[Comparative evaluation of Soviet-made mechanical prostheses in the mitral position].

The authors appraised comparatively the 25 ball prosthesis (group 1), the rotational-disk prosthesis (group 2) and the prostheses (group 3) in 180 patients who underwent operation in the period between 1983 and 1988. The hospital lethality was 7.5% in group 1, 2.7% in group 2, and 4.8% in group 3. After dismissal from the clinic 98.2% of patients were studied in postoperative periods of 6 months to 5 years. Five-year survival after operation was 76.6 +/- 3.6%, 97.3 +/- 0.8%, and 87.7 +/- 1.2%, respectively. By the 5th postoperative year, no thromboembolic complications were encountered in 88.3 +/- 3.6% of patients in group 1, 97.3 +/- 0.8% of patients in group 2, and 91.5 +/- 2.4% of patients in group 3. The mean diastolic gradient was 7.05 +/- 0.75 mm Hg on the prosthesis, 3.98 +/- 0.44 mm Hg on the prosthesis, and 4.27 +/- 0.47 mm Hg on the prosthesis. At the time of the examination, 87.5% of group 1 patients, 88.2% of group 2 patients, and 87.1% of group 3 patients were related to I and II functional classes.

Heart Valve Prosthesis↗
PubMed1990

[Reoperations after insertion of heart valve prosthesis].

The authors analysed 167 repeated operations after heart valve prosthetics, which were conducted from 1978 to 1988. The operations were undertaken for the second time mainly in a severe contingent of patients. The reasons for the repeated operations were specific complications according to which 2 groups of patients were set apart: with dysfunction of the prosthesis of noninfectious origin and with prosthetic endocarditis. Study showed that repeated operative intervention undertaken in time reduces considerably its risk and produces a stable positive effect in most cases.

Adolescent↗
PubMed1990

[Surgical treatment of endocarditis following heart valve prosthesis].

Experience of many years in surgical treatment of prosthetic valve endocarditis (RVE) is analyzed. Patients whose condition was serious were operated on for a second time: 91.6% had preoperative functional class IV, in half of them circulatory disorders were of stage IIB--III; 62.4% were subjected to reoperation for emergency indications. Twenty-five reoperations were performed for early PVE with 52% hospital mortality, 23 reoperations-for late term PVE with mortality of 30.4%. The most frequent cause of PVE was staphylococcal infection which showed a tendency to increase in the recent years. In early PVE the severity of the condition in the recent years. In early PVE the severity of the condition was due to sepsis and intoxication, in late-term PVE it was caused by disorders of hemodynamics which were usually induced by dysfunction of the prosthesis. The results of surgical management of PVE depended on the severity of the patient's condition before the operation, timely performance of the operation, and the efficacy of antibacterial therapy.

Adolescent↗
PubMed1989

[Clinical characteristics of the Soviet low-profile heart valve prostheses EMIKS and LIKS].

The present work is devoted to the clinical assessment of the Soviet-made cardiac valve prostheses 'EMIKS' and 'LIKS'. From 1983 to May 1, 1988, 632 prostheses were implanted to 508 patients. A group of 348 patients were assessed: 139 after mitral (M) replacement, 130 after aortal (A) replacement, and 79 after mitral-aortal (M+A) replacement. Hospital mortality rate was: in M group--4.3 per cent, in A group--5.3 per cent, in M+A group--8.8 per cent. Survival rate on the fifth postoperative year was: in M group--89.5 +/- 9.2 per cent, in a group--90.0 +/- 4.2 per cent, in M+A group--91.0 +/- 6.2 per cent, the stability of the good results being 85.5 +/- 7.2, 79.5 +/- 6.2, and 75.0 +/- 9.1 per cent, respectively. At year 5 of the follow-up, patient numbers without thromboembolic complications amounted to 95.0 +/- 4.7 per cent in M group, 95.5 +/- 4.2 per cent in A group, and 85.0 +/- 9.1 in M+A group. 95.1 per cent patients belong to functional classes I and II. In mitral replacement, the mean 'EMIKS' gradient was 4.2 +/- 0.58 mm Hg, the 'LIKS' one--4.58 +/- 0.62 mm Hg. Intravascular hemolysis was not observed. The 'EMIKS' and 'LIKS' prostheses match the models produced in other countries. No significant differences between the two models were found.

Aortic Valve↗
PubMed1989

Surgical treatment of infective endocarditis in the active stage.

The study summarizes the results of surgical treatment of active infective valvular endocarditis (IE) in two cardiac surgical centres in Hungary and the Soviet Union between 1969-1987. Most (92.9%) of the 241 patients operated on were in severe condition pre-operatively (NYHA Class III and IV), their mean age was 38.2 years. The infectious process was localized predominantly on the aortic valve (169 patients), and developed on previously normal valves in 151 patients. Hospital mortality was 17%, the underlying cause of death was often heart failure, sometimes associated with sepsis. Late mortality was 12.5% (25 patients), only six of these patients died of recurrent infection. The authors stress the high efficacy of surgical treatment of active valvular IE.

Actuarial Analysis↗
PubMed1989

Surgical treatment of dissecting aneurysm of the ascending aorta: immediate and late results.

The authors describe experience gained with surgical treatment of dissecting aneurysm of the ascending aorta in the period from 1978 to 1987. 30 patients were operated on using the techniques proposed by Bentall, De Bono and Carbrol. All patients exhibited the presence of annulo-aortic ectasia. Hospital mortality in the past four years was 20%. On the basis of an analysis of immediate and late results the authors come to the conclusion that Bentall's, De Bono's and Cabrol's technique is the method of choice for surgical corrections of annulo-aortic ectasia and Marfan's syndrome.

Adult↗
PubMed1988

[Immediate results of the surgical treatment of aneurysms of the ascending aorta associated with aortic insufficiency].

Experience with surgical treatment of ascending-artery aneurysms with concomitant aortic insufficiency is summed up. Forty-four patients were operated on, 30 of those having dissecting aneurysm of the ascending aorta. There were 6 operations where coronary arterial openings were isolated and stitched into a valve-containing conduit and 8 supracoronary resections with prosthetic aortic valve implantation. Hospital mortality rate was 78.6%. Thirty patients underwent Bentall-De Bono operation or Cabrol's operation. Hospital mortality was 26.6%. As surgical techniques and corrective methods improved, hospital mortality could be considerably reduced (to 7.7%).

Adult↗
PubMed1988

[Surgical treatment of aneurysm of the ascending aorta in Marfan syndrome].

An experience with 26 operations for aneurysms of the ascending aorta with a concomitant insufficiency of the aorta valve in Marfan syndrome is described. We started using operations after Bentall-De Bono in 1979 and operations after Cabrol in 1983 which were used in cases with low localization of openings of the coronary arteries in relation to the fibrous ring of the aorta valve, as well as in cases with the dissecting aorta wall, especially involving the area of the openings. These operations allowed the intrahospital lethality to be reduced: in the period of 1979-86 it made up 30% (6 patients died out of 20), in 1983-86 it was 15.4%, in 1986 it was 12.5%.

Adult↗
PubMed1988

[Possibilities of cardiac surgery in the treatment of active valvular infectious endocarditis].

The results of surgical treatment of 142 patients with active valvular infectious endocarditis are reviewed. Hospital mortality was 15.5% (22 patients died). Follow-up covered 6 months to 14 years (with an average of 3.5 years) in 108 patients. Ten (9.3%) patients died over this period, and 11 (10.2%) showed indifferent or poor results of surgery. Within 5 years, total survival rate was 74.4%, including hospital mortality, and good late results were seen in 76.8% of the discharged patients. Surgical treatment of active valvular infectious endocarditis is shown to be a fairly effective method and should be used on a larger scale in clinical practice.

Adolescent↗