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Biomedical subjects

G V Babalian

Publications and source records attributed to G V Babalian.

At least 19 recordsLinked to original sources

[Surgical treatment of giant aneurysms of ascending parts and arch of the aorta in condition of deep hypothermia and circulatory arrest with artificial assisted circulation].

Sternotomy in giant (10 cm and more in diameter) aneurysms is highly dangerous due to possibility of injury of aneurysmatic wall with fatal bleeding. That is why sternotomy in condition of artificial circulation (AC) and cooling of patients to 29-30 degrees C are preferred. Two cases of successful surgical treatment of critical patients with giant aneurysms of ascending parts and arch of the aorta in condition of femoro-femoral AC, hypothermia (20 degrees C) and circulatory arrest are presented. One of the patients had a giant false posttraumatic aneurysm of an ascending part of the thoracic aorta with fistula between aneurysm and pulmonary artery. Suturing of defects of ascending aorta and pulmonary artery wall, aneurysmorrhaphia of pulmonary artery were performed. The other patient with acute disruption of a giant dissected aortal aneurysm and hemomediastinum underwent prosthesis of ascending part and arch of the aorta.

Aortic Dissection↗

[Aortic valve prosthesis implantation from a mini approach].

The authors share their experiences with performing the first in Russia operation of making the aorta valve prosthetics from a mini-access--transverse sternotomy. It is concluded that operations through such accesses are safe for the patient and relatively easy for the surgeon. Its main advantage consists in quick surgical rehabilitation of the patient and good cosmetic effect.

Adult↗

[Heart transplantation conducted at the All-Union Research Center of Surgery (the first clinical experience)].

The authors analyse experience in the first eight operations for orthotopic transplantation of the heart. Six patients were discharged from the clinic with good immediate results. Comparison of their own data with summarized results gained in other countries allowed the authors to define some specific problems which are of practical interest for clinics embarking on the clinical realization of the problem of heart transplantation.

Adult↗

[Diagnosis of aortocoronary bypass complications].

Thirty-four patients with ischemic heart disease were examined during operation for revascularization of the myocardium. The blood flow in the shunts was measured during the change from extracorporeal to natural circulation. In rise of venous and arterial pressure the blood flow in the shunts increased (positive dynamics) in some patients and decreased (negative dynamics) in others. Positive dynamics were associated with a favourable course of the postoperative period, negative dynamics--with ischemic-type complications. Factors invalidating the myocardium aggravated the initial condition of patients with positive dynamics of the blood flow less than that of patients with negative dynamics. Comparison of dynamic and short-term measurement of the blood flow in the shunts as a diagnostic test for perioperative complications showed the advantage of the dynamic test.

Adult↗

[First clinical test of the use of artificial blood circulation with auto-oxygenation].

Thirteen operations for ischemic heart disease were performed in the All-Union Surgery Centre of the AMS USSR using the method of simultaneous left and right heart bypass with oxygenation of the blood in the patient's lungs. This method was found to provide for a better gas exchange in artificial lung ventilation (ALV) with 30 per cent oxygen in the inhaled mixture, and for the reduction in the perfusion blood damage. The biventricular bypass is more complicated technically than the conventional artificial circulation (AC), but it is believed to be more physiological and cost-effective, which allows for considering it an alternative in aortocoronary bypass surgery.

Adult↗

[Methodological aspects of contrast echocardiography].

Contrast echocardiography was applied in the examination of 38 patients with various congenital and acquired heart diseases. The dye cardiogreen and physiological saline solution were used as the contrast medium. The technique of contrast echocardiography is described. It is shown that the method of contrast echocardiography allows one to visualize the direction in which the intracardiac streams of blood move, which makes it possible to use the method in the diagnosis of septal defects and cardiac valve insufficiency.

Adolescent↗

[Combined spinal-epidural and epidural anesthesia in operations on the vessels of the lower extremities].

Eighty-eight anesthesias in patients operated on the lower limb vessels are analyzed. In group 1 (77 pts) combined spinal-epidural anesthesia (CSEA) was used, in group 2 (16 pts) epidural anesthesia (EA). Segmentary blocking was induced by 2% lidocaine and 0.5% bupivacaine. CSEA was characterized by a shorter (in comparison with EA) latent period (12.9 +/- 1.3 min vs. 24.7 +/- 3.4 min, p < 0.05), a lower dose of bupivacaine (lidocaine: 735 +/- 89 mg in CSEA and 848 +/- 92 mg in EA; bupivacaine: 28.3 +/- 7.2 mg in CSEA and 92.6 +/- 8.5 mg in EA, p < 0.01), and a higher reliability. Combined anesthesia with bupivacaine is characterized by a greater contribution of the spinal component (than with lidocaine) and thus improve the quality of anesthesia, decrease the anesthetic dose, and maintain the stability of hemodynamic parameters. Four cases with inadequate blocking were due to erroneous position of the epidural catheter. Accidental perforation of the dura mater occurred in two patients, and prolonged spinal anesthesia was carried out. No headaches ensued. Hence, CSEA should be preferred to common prolonged EA in operations on the lower limb vessels.

Analysis of Variance↗

[Anesthesia, changes in hemodynamics and metabolism in surgical treatment of thoracic and abdominal aortic aneurysms].

45 patients aged 32-63 years operated on for dissecting aneurysm of the thoracoabdominal part of the aorta were divided into 2 groups. Group 1 patients (n = 36) were operated on with application of the bypass using centrifuge pump. Group 2 patients (n = 9) were operated on without the bypass. The results evidence that the employed anesthesia and infusion therapy in combination with the bypass maintained by the pump provide stable intraoperative hemodynamics and prevent renal failure. Usage of the bypass in combination with liquor drainage reliably protects spinal cord from ischemia, especially in patients with long-term aortic ligature.

Acid-Base Equilibrium↗

[Autonomic reactivity and intraoperative arterial hypertension in patients with ischemic heart disease].

As patients with ischemic heart disease (IHD) may develop intraoperative hypertensive and hyperdynamic reactions provoking myocardial ischemia, the authors estimated reactivity of the autonomic nervous system before giving anesthesia. This was made for prediction of intraoperative hypertensive reactions and choice of an optimal anesthesia variant. Combination of spectral analysis of variability of the heart rhythm and active orthostatic test was employed for this purpose in 50 IHD patients undergoing myocardial revascularization.

Adult↗