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Biomedical subjects

G V Knyshov

Publications and source records attributed to G V Knyshov.

At least 19 recordsLinked to original sources
PubMed2002

[Diagnosis and treatment of biatrial myxomas of the heart].

Of the multiple myxomas of the heart (MH) the bilateral myxomas were revealed in 57.1%. Of 4 patients before the operation the correct diagnosis was established only in one. Meticulous data on clinical signs, diagnosis and surgical treatment peculiarities of patients with bilateral MH were adduced. Morphological peculiarities of the tumor were analyzed. Special attention was paid to the necessity of clinical and surgical guard toward revelation of undiagnosed tumors, the choice of optimal approaches to the heart cavities while performing radical operation. Basing on results of histological studying of operational specimen it was established that MH is originated from transformed vessels of interatrial septum.

Adult↗
PubMed2002

[Surgical treatment of the aortic arch aneurysm. Immediate results].

There was performed the retrospective analysis of 23 consecutive patients, to whom beside the ascending aorta aneurysm correction the aorta arch prosthesis was done in conditions of deep hypothermia, the blood circulation arrest with retrograde cerebral perfusion via vena cava superior. For an acute layering and aneurysm of aorta with pericardium tamponade or hemothorax occurrence 16 (69.6%) of patients were operated on in emergency. Hospital mortality had constituted 21.7%, including after an urgent operation performance--25% and elective surgery--14.3%.

Adult↗
PubMed2001

[Changes in immune status in patients with infectious endocarditis in surgical treatment involving artificial blood circulation].

In 98.2% patients with infectious endocarditis, admitted to the hospital for surgical treatment, the moderate immune deficiency state is revealed with the cell link of immunity depression and phagocytic function of neutrophils insufficiency, which become aggravated after operative intervention performance, especially using artificial blood circulation. The cell link of immunity depression, the B-lymphocytes function inhibition are preserved during 6 months after the operation.

Adult↗
PubMed2000

Surgical treatment of Wolf-Parkinson-White syndrome during plastic operations in patients with Ebstein's anomaly.

OBJECTIVE: Ebstein's anomaly is the most common pathology associated with the accessory conduction pathways. METHODS: From January 1990 to August 1999 48 patients underwent surgical repair of Ebstein's anomaly by various plastic techniques. The pathways were identified and characterized at preoperative electrophysiologic mapping in 17 (34.5%) patients. There were seven males and ten females. The patients age ranged 6-35 years (mean 12.7+/-2.1 years). Five patients were in NYHA class II and were in 12 in NYHA class III. The cardiothoracic ratio ranged from 0.59 to 0.69 (mean 0.65+/-0.08). Tachycardia was present in 15 patients with Wolf-Parkinson-White (WPW) syndrome. Atrial septal defect was present in 12 patients (70. 6%). Accessory conduction pathways were in the right posterior septal area in seven patients, in right posterior septal area and free wall in seven patients and in right free wall in three. The pathways were successfully ablated in all patients during cardiopulmonary bypass. RESULTS: There were no deaths, no relapses. Follow-up ranged from 4 months to 7 years (mean 4.7+/-1.1 years). There were no late deaths, but one patient required successful tricuspid valve replacement because of severe tricuspid insufficiency. At follow-up 57.8% of patients were in NYHA class I. CONCLUSIONS: Preoperative electrophysiologic study allows to identify the accessory conduction pathways in patients with Ebstein's anomaly. The combined approach of tricuspid valve repair and surgical ablation of accessory atrioventricular connections has been proved safe and effective. This operative procedure allows to improve functional results in patients with Ebstein's malformation and concomitant accessory conduction pathways.

Adolescent↗
PubMed1996

Aortic aneurysms at the site of the repair of coarctation of the aorta: a review of 48 patients.

BACKGROUND: Study of the long-term results from 1 to 24 years after coarctation of the aorta repair in 891 patients showed that in 48 (5.4%, Mean age, 30.9 +/- 1.1 years) aneurysms had developed at the site of repair. Aneurysms arose in 43 (89.6%) of the patients in whom repair was done with help of synthetic patch aortoplasty, in 4 (8.3%) of the patients after coarctectomy with "end-to-end" anastomosis, and in 1 patient (2.1%) after coarctectomy with a prosthetic graft replacement. METHODS: Reoperation included aneurysm resection, which was performed in 30 patients (62.5%), followed by prosthetic graft replacement (n = 19), synthetic patch aortoplasty (n = 6), aneurysmorrhaphy (n = 3), or prosthetic bypass graft (n = 2). RESULTS: Four (13.8%) patients died after reoperation. All 18 patients who were not reoperated on died of a ruptured aortic aneurysm 7 to 15 years after repair of coarctation of the aorta. CONCLUSIONS: With the aim to prevent aneurysm development at the site of coarctation of the aorta repair, severe limitation of indications for synthetic patch aortoplasty is necessary. It can be used only in adult patients with a not too big narrowing. Patients after primary correction of coarctation of the aorta must avoid strenuous physical activity. Chest roentgenography should be performed in these patients each year, and each year they have to be seen by a cardiac surgeon. Suspicion of aneurysm development demands hospitalization, aortography, and reoperation. Preference is given to prosthetic graft replacement using an approach through the left fourth intercostal space with distal circulatory support by means of temporary bypass shunting. Infected aneurysms can be primarily bypassed through the right anterior thoracotomy with the creation of permanent bypass with the help of a vascular graft between the ascending and descending thoracic aorta.

Adolescent↗
PubMed1994

[The morphological evaluation of a heart ventricle made from the latissimus dorsi muscle in an experiment].

In experiment of 16 animals the morpho-functional transformations taking place in skeletal-muscular transplant while various methods of artificial heart ventricle creation and his training application were studied. It was established that, as a rule, in autotransplant the reversible structural changes are taking place, what stipulates the necessity of keeping of the "latent" period 14-21 days long between the operation conducted and the beginning of training stimulation of heart ventricles, manufactured of a skeletal muscle.

Adaptation, Physiological↗
PubMed1994

[New biological vascular prosthesis made of avian trachea].

New biologic prosthesis of the arterial vessels manufactured of the bird trachea was elaborated and approved upon the test bench and experimental conditions. Sufficient mechanical durability and elasticity of the prosthesis was ascertained, alike the possibility of his application for the arterial vessels replacement. New bioprosthesis have such advantages as handiness at work, steadiness for twist and deformation, negligible thrombogenicity, relatively high endothelialization speed, functioning stability and nonreactivity.

Animals↗
PubMed1993

[Method of surgical treatment of mitral valve stenosis depending on the extent of its calcinosis].

On the basis of studying the immediate and long-term results of treatment of 329 patients with calcinated mitral stenosis, the progressive aggravation of the immediate outcome of the operation in II and III-IV degree of mitral valve calcinosis is demonstrated. The data have been confirmed by actuarial analysis of the patients' survival and stability of a good result. The authors consider it expedient to perform mitral commissurotomy only in patients without valvular calcinosis and I degree calcinosis. In more severe affection, mitral valve replacement is indicated.

Actuarial Analysis↗
PubMed1992

[In vivo analysis of the morphofunctional state of myocardial blood supply in ischemic heart disease].

The patency of coronary arteries and morphofunctional features of myocardial microhemocirculation were studied in 40 males with coronary heart disease (CHD) aged 36-59 using intravital coronary angiography, intraoperative left ventricular biopsies assessed electron-microscopically and by semithin sections. In spite of various impairment of the coronary arteries, there was similar clinical presentation. It was found that in addition to atherosclerosis stenosing the main subepicardial vessels in CHD, there appeared a peripheral barrier for the tissue circulation with defective permeability of the myocardial microvessels. Intramyocardial vascular disorders were characterized by noticeable changes in blood rheology, reactivity of resistive vessels and angiosclerosis. The role of multifactor endothelial deformities rose significantly as well as of extravasal compression of the microvessels in interstitial edema and sclerosis, in affected cardiomyocytes. Moreover, the permeability of the histohematic barrier came to be destroyed. The above changes can be considered as reversible, irreversible and amenable to correction. The findings led the investigators to the conclusion on a role of the dysfunction of the intramyo cardial vascular bed as an essential mechanism of CHD pathogenesis responsible for realization of the functional factors.

Adult↗
PubMed1992

[The prognostic assessment of the reversibility of myocardial dysfunction in patients with ischemic heart disease after aortocoronary bypass].

Forty-six patients with ischemic heart disease with considerable dysfunction of the myocardium were subjected before operation of aortocoronary shunting to veloergometry with calculation of indices of the central hemodynamics by the method of tetrapolar rheoplethysmography, echocardioscopy before and after taking nitroglycerin. Close interrelation was noted between the increase of the stroke volume during veloergometry, increased fraction of output after taking nitroglycerin and improved contractile capacity of the myocardium after aortocoronary shunting.

Coronary Artery Bypass↗
PubMed1992

[The hemostatic system and the status of aortocoronary venous autografts in patients with ischemic heart disease after surgery for direct myocardial revascularization based on autopsy research data].

The study was undertaken to examine the relationship between the major hemostatic factors in the early postoperative period and the status of an autovenous graft in 19 patients with coronary heart disease who died 3 to 40 days after aortocoronary bypass surgery. The hemostatic system was monitored on the patients' admission and during the whole observation. Hypercoagulation was recorded in all patients in the first postoperative hours. A trend towards hypercoagulation during the entire period of observation was more marked in 7 patients whose postmortem study revealed even one nonfunctioning graft than in 12 patients with maintained patency of all grafts. The major parameters associated with graft thrombosis were platelet aggregation, ethanol test, and levels of soluble fibrin monomer components. Platelet aggregation and the presence and degree of soluble fibrin monomer components were of independent correlative significance. The magnitude of degenerative and proliferative changes in the vein was associated with the interval after the surgery. Myocardial infarction in the early postoperative period was related to graft dysfunction.

Aorta↗
PubMed1992

[Progressive changes in the coronary arteries in patients with ischemic heart disease after aortocoronary bypass].

To examine the time course of changes in the coronary arteries in patients with coronary heart disease after aortocoronary bypass (ACB), the authors studied 2 groups of patients: (1) 23 who had conservative treatment and (2) 23 who were selected for ACB. Repeated angiography was performed 14.6 +/- 2.5 months after the initiation of the study. Following ACB, changes in lesions were observed in 17 coronary artery segments in 39.1% of the patients. Grafted artery stenoses largely proximal to the site of transplantation became progressive. There was a relationship between the changes in coronary arteries to graft patency. In Group 1, the time course of coronary atherosclerosis was found in 8 segments in 26% of the cases. Atherosclerosis progressed in all artery segments virtually in a steady way. Application of vein grafts may change intracoronary hemodynamics, creating conditions for more rapid and common progression of coronary artery lesions.

Adult↗
PubMed1991

[Surgical treatment of supraventricular tachycardias in children].

The paper deals with the results of surgical treatment in 19 children with supraventricular tachycardias. Eighteen patients were found to have the Wolff-Parkinson-White syndrome and one presented with ectopic right atrial tachycardia. The accessory pathways in the free wall and anterior septum in the presence of the Wolff-Parkinson-White syndrome were eliminated on the working heart, whereas those in the posterior septum were removed during extracorporeal circulation via endocardial access. Ectopic right atrial tachycardia was arrested by arrhythmogenic area resection in the right atrium during extracorporeal circulation. A positive result of the operation was achieved in 17 of the 18 patients. At day 2 of postsurgery, one patient developed recurrent tachycardia that was eliminated during a repeated operation. Which optimal method should be chosen to remove accessory pathways is discussed in the paper.

Adolescent↗
PubMed1991

[Coronary surgery from the aspect of ambulatory care follow-up].

The authors observed for a long-period 453 patients with the ischemic heart disease after the operation of aorto-coronary shunting (ACS). At discharge from the hospital, in 96.9% of the patients operated on, the clinical improvement of the state was noted, in 78.4% of them, the attacks of angina disappeared. Five years later, in 46.1% of the patients examined, there were no stenocardia, in 53.9%, retrosternal pain was noted. According to the findings of repeated coronarography, development of the stenocardiac syndrome is caused by insufficient function of the venous shunts and aggravation of stenosing atherosclerosis. By means of twin pharmacodynamic tests, it was established that monotherapy and combined therapy with calcium antagonists were the optimal ones.

Ambulatory Care↗
PubMed1991

[Surgical treatment of ischemic heart disease associated with lesions of the valvular apparatus of the heart].

Every fourth patient over 45 years of age in a group of patients with valvular heart diseases suffers from affection of the coronary arteries. Experience in 71 operations for the combination of these diseases showed that the success of surgical treatment is determined by the method of myocardial protection. First the shunts are sutured and then additional cardioplegia is carried out through them. Valvular prosthetics is performed after that. Blood cardioplegia is preferred. Most surgical failures are connected with the complex character of the initial pathology. The direct and late-term results show the developed method for surgical management of this complicated pathology is effective and justified.

Adult↗
PubMed1991

[Effects of calcium antagonists on the pattern of intracardiac hemodynamics and functional state of the myocardium in patients with angina pectoris relapsing after aortocoronary bypass operation].

The hemodynamic pattern of the antianginal effects of calcium antagonists was examined in 111 patients with Functional Classes II-IV angina pectoris relapsing on an average of 36.7 +/- 1.1 months following aortocoronary bypass surgery, as evidenced by radionuclide ventriculography performed in the acute drug test with finoptin and corinfar. The clinical and functional status improved in 49 patients on finoptin and in 62 on corinfar. In three fourths, the efficacy of finoptin was achieved by decreased myocardial diastolic stiffness and only in a fourth, it was due to lower afterload. In three fourths, the efficacy of corinfar was attained by the action of the vascular component and only in a fourth, it was attributable to its effects on diastolic relaxation--to its direct action on the myocardium.

Adult↗