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Iu S Petrosian

Publications and source records attributed to Iu S Petrosian.

At least 19 recordsLinked to original sources
PubMed1992

[The treatment of critical valvular stenosis of the pulmonary artery by the balloon valvuloplasty method in patients in the first 3 years of life].

The work generalizes the experience of the Bakulev Institute of Cardiovascular Surgery in balloon valvuloplasty of valvular pulmonary stenosis in 58 children of the first 3 years of life: 8 were 1 to 6 months of age, 10 were 7 to 12 months of age, 18 were 13 to 24 months old, and 22 were 25 to 36 months old. Cyanosis was found in 27 of them. As the result of balloon valvuloplasty, the systolic pressure gradient between the right ventricle and the pulmonary artery reduced from 114.7 +/- 12.6 to 31.4 +/- 7.2 mm Hg in children under 1 year of age, from 143 +/- 12.6 to 40.1 +/- 8.3 mm Hg in children aged from 1 to 3 years. In patients with cyanosis, saturation of arterial blood with oxygen increased to 92%. The late-term results were studied in follow-up periods of 6 to 36 months in 35 patients, by means of catheterization and angiocardiography in 15 of them. Analysis showed balloon valvuloplasty to be effective. Balloon valvuloplasty was repeated in 5 patients with critical stenosis because a hemodynamic effect was not achieved by the first dilatation.

Catheterization↗
PubMed1992

[Transluminal balloon valvuloplasty in the treatment of congenital critical aortic valve stenosis in infants in the 1st year of life].

Balloon valvuloplasty was performed in 14 patients with congenital valvular aortic stenosis. Their age was 28 days to 12 months. All the patients had severe heart failure. Balloon valvuloplasty was successfully conducted in 8 patients. The systolic pressure gradient between the aorta and the left ventricle decreased, on the average, from 81.2 +/- 21.4 to 31.3 +/- 8.2 mm Hg, i.e. by 61.5%. Only 2 patients developed moderate aortic insufficiency after balloon valvuloplasty. The left ventricle could not be catheterised in 6 infants: in 4 patients due to critical valvular stenosis, in 2 due to a. lusoria. One of them died when the guide was attempted to be introduced through the narrowed aortic valve, which resulted in aortic sinus perforation. Long-term results were studied in 4 patients 3 to 24 months after surgery. Their clinical condition improved. The systolic pressure gradient between the left ventricle and the aorta was in agreement with the values obtained just after transluminal balloon valvuloplasty. Transluminal balloon valvuloplasty can be successfully performed in 1-year-old infants with congenital critical aortic valvular stenosis and yields good immediate results. A further accumulation of clinical findings, development of procedures for transluminal balloon valvuloplasty and study of long-term results will allow indications for this tool to be worked out in this group of patients.

Acute Disease↗
PubMed1991

[Complications of catheter-balloon valvuloplasty (analysis of their causes and the methods of prevention and treatment].

The authors analyse the results of 1,404 operations of catheter-balloon valvuloplasty in stenoses of the pulmonary, aortic, and mitral valves. The experience was accumulated by the leading heart surgeons of the country from 1984 to 1990. The total number of complications was 77 (5.4%), 23 (1.6%) of them were fetal. The least number of complications (1.88%) occurred in catheter-balloon valvuloplasty in pulmonary stenosis, 1% were fetal. Complications in aortic stenosis were encountered in 11.3% of cases, 4.8% were fatal. The greatest number of complications (44) were recorded in mitral stenosis with a relatively low mortality (2.7%). The authors distinguish unspecific complications connected with the use of standard diagnostic catheters and instruments, and specific complications linked with the use of balloon catheters or caused by the course of the disease, and the character of the valve affection. As the result of analysis of the causes of complications, the authors suggest a system for preparation of patients for operation and the principles of its safe accomplishment and describe the order of the acts undertaken by the surgeon for the management of complications. Analysis of complications of catheter-balloon valvuloplasty demonstrates the efficacy and mild injurious character of this method, which makes it possible to rank it among the generally accepted cardiosurgical methods for the correction of heart valvular stenoses.

Aortic Valve Stenosis↗
PubMed1990

[Transluminal balloon angioplasty of pulmonary arteries after palliative reconstruction of the outflow tract from the right ventricle as a preparatory stage for radical surgery].

The authors describe their experience in the use of transluminal balloon angioplasty (TBA) of the pulmonary arteries (PA) carried out in stenosed segments in the late-term period after operation for palliative reconstruction of the right ventricular outflow tract without closure of a ventricular septal defect (VSD) in 7 patients: in 6 with Fallot's tetrad after previously created systemic-pulmonary anastomoses and in one with PA atresia and VSD. TBA was conducted in 11 stenosed segments of the pulmono-arterial tree. The TBA method is suggested as a procedure for preparing the PA for the final stage of operative treatment.

Adolescent↗
PubMed1990

[Intravascular radiologically-guided surgery in the treatment of congenital heart defects].

The article discusses the experience of the Bakulev Institute of Cardiovascular Surgery, USSR AMS, in catheter endovascular radiologically-guided surgery of some congenital heart diseases in the period from 1967 to 1990. A total of 505 operations were performed at the department of radiologically-guided examination and treatment of the heart and vessels: 307 Rashkind's and 35 Park's operations in total transposition of the great vessels, 110 balloon dilatations in valvular stenosis of the pulmonary trunk and 13 in valvular stenosis of the aorta, 7 embolizations in coronary-cardiac fistulas, 2 balloon dilatations in constrictions of Blalock-Taussig anastomosis, 14 balloon dilatations in peripheral stenoses of the pulmonary arteries, etc. The methodical aspects and the results of endovascular interventions are discussed in detail. The data of foreign researchers on the promising methods of radiologically-guided surgery are also shown.

Adolescent↗
PubMed1990

[Angiographic signs and pathophysiology of abnormal origin of the left coronary artery from the pulmonary trunk].

The results of intracardiac examination of 37 patients with anomalous origin of the left coronary artery from the pulmonary trunk were studied. On the basis of anatomo-angiographic++ comparisons the authors point out the characteristic features of coronary circulation and affection of the left ventricular myocardium which determine the clinical manifestations of its dysfunction. The functional condition of the left ventricle was appraised depending on the character of development of the intercoronary collaterals.

Adolescent↗
PubMed1989

[Transluminal balloon valvuloplasty and aortoplasty in the treatment of congenital heart defects].

The authors' experience in endovascular treatment of such congenital heart defects as pulmonary valvular stenosis (PVS), aortic valvular stenosis (AVS), and aortic coarctation (AC) is presented. Transluminal balloon dilatation was performed in 46 patients: in 30 patients with PVS, 11 patients with CA, and 4 patients with AVS, the patients' age ranging from 7 months to 45 years. Transluminal balloon valvuloplasty was performed using 'Schneider-Medintag' catheters (Switzerland). In PVS patients, the systolic pressure in the right ventricle (RV) was reduced after the procedure from 129 +/- 10.4 to 58 +/- 3.5 mm Hg, the systolic pressure gradient (SPG) between the right ventricle and pulmonary artery fell from 111 +/- 10.6 to 35 +/- 3.8 mm Hg, and the pulmonary valve opening was enlarged from 13.4 +/- 1.5 to 69 +/- 3.9 mm2. Late (6-18-month) results were studied in 5 patients. In CA and reversed CA patients, the SPG between the ascending and descending aorta was reduced from 47.0 +/- 1.7 to 16.0 +/- 3.7 mm Hg, the coarctation diameter increased from 4.5 +/- 0.6 to 8.2 +/- 2.3 mm. In congenital AVS patients, the SPG between the left ventricle and aorta was reduced from 106.5 +/- 35.1 to 39.5 +/- 8.1 mm Hg. Thus, the transluminal balloon valvuloplasty is an effective therapeutic intervention and might be an alternative to surgical treatment. Further experience will allow one to specify indications to its performance in congenital heart disease.

Adolescent↗
PubMed1989

[Endovascular laser methods in the treatment of arteriosclerotic cardiovascular diseases].

Employment of laser for restoration of adequate blood flow in atherosclerotic vessels is a radically new approach to treatment of cardiovascular diseases of atherosclerotic genesis. Since 1983, wide-scale experimental work has been done at A.N. Bakulev Institute of Cardiovascular Surgery, USSR Academy of Medical Sciences, which has formed the basis for transluminal laser angioplasty (vascular recanalisation with high-intensity laser beam), laser atherolysis (regression of atherosclerotic formations under low-intensity laser beam), and their combinations. Clinical application of these procedures was started in 1985. Sixty-two patients with ischaemic heart disease, Takayasu's and Leriche's syndromes, chronic occlusion of pelvic and lower-limb arteries, and with combined lesions of the arterial bed were exposed to targeted transluminal laser. Laser endovascular therapy alone and in combination with balloon angioplasty or bypass surgery was used. Application of these methods showed their high efficacy. Successful recanalisation and restoration of adequate flow (confirmed by Doppler echography and angiography) were achieved in 93 per cent cases; results were poor (no effect, complications) in 7 per cent cases.

Adrenergic beta-Antagonists↗
PubMed1989

[Left-ventricular relaxation in patients with ischemic heart disease, congestive cardiomyopathy and mitral and aortic valve defects].

Left ventricular relaxation was studied in 105 patients with coronary heart disease (CHD), 42 with mitral and aortic valvular diseases, and 14 with congestive cardiomyopathy. To assess the left ventricular relaxation, the values of dP/dt and T time constants for isovolumic exponential fall in intraventricular pressure were defined in the patients. Depressed left ventricular relaxation was found in the majority of the patients with CHD whatever the status of global and segmental pumping function of the left ventricle. Abnormal left ventricular relaxation turned out to be a characteristic feature in patients with congestive cardiomyopathy and valvular diseases that contributed to the generation of left ventricular overload by its pressure and volume. In CHD patients, depressed relaxation was accompanied by lower volume and slower early diastolic filling of the left ventricle.

Cardiac Output, Low↗
PubMed1989

[Tl-201 perfusion scintigraphy of the myocardium in patients with anomalous origin of the left coronary artery from the pulmonary trunk (clinico-anatomical comparisons)].

The clinical significance of 201Tl myocardial perfusion scintigraphy was studied in 7 patients with abnormal branch of the left coronary artery from the pulmonary trunk and in 1 patient with that of the anterior interventricular artery from the pulmonary trunk. Radiological criteria for the defect were established on the basis of comparative analysis of the data of myocardial scintigraphy with those of electrocardiographic, coronary angiography and anatomic examinations. It was shown that it was feasible to make a differential diagnosis between abnormal left coronary artery branch and dilated cardiomyopathy and that the technique was of value for comparative assessment of the efficacy of various types of surgical treatment for abnormal left coronary artery ramus from the pulmonary trunk.

Adolescent↗
PubMed1988

[Characteristic features of the pathological anatomy and involvement of the myocardium in anomalous branching of the left coronary artery from the pulmonary trunk (Clinico-anatomical comparisons)].

Pathologic, clinical and anatomical correlations are presented for left ventricular affection in abnormal origin of the left coronary artery from the pulmonary trunk. It was revealed that there is a complex of critical factors essential for survival of patients and clinical pattern of the defect including the degree of manifestation of intercoronary collateral circulation, specificity of myocardial left ventricular ischemic impairment and that of mitral structure. Clinical and anatomical comparisons are drawn between the degree of affection of the left ventricular myocardium and its functional capacity.

Adolescent↗
PubMed1988

[Hemodynamic mechanisms of ECG changes in congenital fistulas of the coronary arteries].

ECG changes were analysed in 31 patients with congenital coronary arterial fistulas with reference to the site of coronary arterial lesion and the level and magnitude of blood discharge. Two hemodynamic factors, conditioning ECG changes, were identified as typical for coronary arterial fistulas: 1) volume strain on cardiac compartments making up the fistula receptacle chamber; 2) perfusion deficiency in the distal segment of the affected coronary artery. Fistulas with large-volume shunts may be accompanied by both ischemic changes in the affected-artery basin and regional perfusion disorders in adjacent basins, the latter being due to "stealing" of the adjoining coronary trunk or the type of coronary blood supply.

Adolescent↗
PubMed1988

[Effect of the rheological properties of the blood on the intracardiac hemodynamics in patients with acquired mitral valve defects].

A study of 17 patients with prevailing mitral stenosis and 10 patients with prevailing mitral insufficiency demonstrated a significant aspirin-induced improvement of blood rheologic characteristics in all patients that was accompanied with a heterogeneous shift of intracardiac hemodynamics and left-ventricular myocardial pumping activity. For instance, in patients with prevailing mitral stenosis, an improvement of blood rheologic properties is accompanied with a drop in mitral pressure gradient and a decrease in total pulmonary resistance and total peripheral resistance resulting in increased pumping capacity of the heart (increased minute volume, systolic index and stroke index). In patients with prevailing mitral insufficiency, the improvement of blood rheologic properties is accompanied by an increase of regurgitation volume, a reduction of effective ejection fraction and a rise in total pulmonary resistance. Therefore, a differential approach to the use of agents improving blood rheologic properties is needed.

Adult↗
PubMed1987

[Initial experience with transluminal laser recanalization in patients with stenosing arteriosclerosis of the lower extremities].

Early experience with transluminal application of low-intensity laser beam (632 nm) to treat atherosclerotic vascular occlusions in 23 patients with combined disorders (Leriche's syndrome and coronary heart disease) is summed up. The beam was carried to the site of occlusion through special laser catheters developed at the A. N. Bakulev Institute of Cardiovascular Surgery (USSR Academy of Medical Sciences). Objective assessment of blood flow recovery in the ischemized limbs was based on angiography, hemodynamic studies, volumetric sphygmography combined with ultrasonic dopplerography and digital subtraction angiography.

Adult↗