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Biomedical subjects

L R Plotnikova

Publications and source records attributed to L R Plotnikova.

At least 19 recordsLinked to original sources
PubMed1991

[Disorders of cardiac rhythm and conduction after radical correction of tetralogy of Fallot].

The work is based on the results of examination of 78 patients conducted before, in the immediate, and in the late-term periods after the operation (6.5 +/- 5.0 years on the average). Holter's monitoring and bicycle ergometry conducted before the operation revealed rhythm disorders in 55% of patients: complete block of the right limb of the bundle of His in 30, I-III degree atrioventricular block in 9%, supraventricular arrhythmias in 2.5%, ventricular arrhythmias in 5%, and combined arrhythmias in 7.5% of patients. Complete block of the right limb of the bundle of His was discovered in all patients in the late-term postoperative periods, and other types of rhythm disorders were found in 62% of patients: I degree atrioventricular block in 2.5%, bifascicular block in 2.5%, ++tri-fascicular block in 1%, ventricular arrhythmias in 26%, and combined arrhythmias in 30% of patients. The results of the examination showed that: (1) the presence of stable block of the right limb of the bundle of His, bifascicular block, as well as ventricular arrhythmia of I-II gradation after Laun-Wolf does not lead to decrease of myocardial working capacity and contractile function. In contrast, III-IV gradient ventricular arrhythmia is attended by significant diminution of myocardial contractility; (2) the incidence of ventricular arrhythmias grows with increase of the patients' age at the time of the operation and intensification of the degree of initial arterial hypoxemia and the anatomical severity of the anomaly; (3) correction of the anomaly contributes to the disappearance of the preoperative arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Radical correction of Fallot's tetralogy following an earlier Blalock-Taussig anastomosis].

Seventy-nine radical interventions for Fallot's tetralogy after a previously established Blalock-Taussig anastomosis were conducted at Bakulev Institute of Cardiovascular Surgery, AMS USSR, from 1983 to Dec. 1989. The average age at which the radical operation was undertaken was 10.1 +/- 0.4 years. The interval between the two operations ranged from 1 year to 12 years (7.0 +/- 0.2 year on average). Thrombosis of the anastomosis occurred in 2 (2.5%) patients. Development of pulmonary hypertension was not encountered. Complications like "functional atresia" of the right-ventricular outflow tract (5.1%) and acquired atresia of the valve of the pulmonary trunk (2.5%) were encountered when the interval between the two operations was more than 7 years, and developed mostly in patients with the anastomosis formed before the age of 2 years. In 70 (88.6%) patients the subclavian artery was ligated, in 6 the opening of the anastomosis was sutured through the lumen of the respective pulmonary trunk. Surgically significant constrictions of the branches of the pulmonary arteries were revealed in 10 (12.6%) patients, which called for plastic distension during radical correction. In 7 (8.8%) patients the operative interventions were limited to infundibulectomy. Transannular plastics was necessary in more than half of the patients (55.7%). A conduit containing a xenovalve was implanted between the right ventricle and the pulmonary trunk in one (1.3%) patients. Hospital mortality was 6.3% (5 patients died). With a proper surgical approach, complications of the Blalock-Taussig anastomosis produce no essential effect on the results of radical correction, which may be carried out with a mild degree of risk and a low mortality rate.

Adolescent↗
PubMed1990

[Complications of the Waterston-Cooley-Edwards anastomosis and their correction in radical surgery of the tetralogy of Fallot].

The work is based on the analysis of complications of Waterston-Cooley-Edwards anastomosis which create tactical and technical difficulties in correction of Fallot's tetralogy. Rational methods for their correction are suggested. From January, 1982 to April, 1989 a total of 133 radical operations were carried out for Fallot's tetralogy in patients with Waterston-Cooley-Edwards anastomosis formed earlier; mortality was 6%. Negative sequelae of the anastomosis were found in 62 (46.6%) patients. These were: pathology of the right pulmonary artery in 33 (27%) patients, functional atresia of the outflow paths from the right ventricle in 11 (8.3%), acquired atresia of the valve of the pulmonary artery in 2 (1.5%), pulmonary hypertension in 12 (9%), and acquired cavopulmonary fistula in 1 (0.8%) patient. Despite the rather large number of complications, most of them were successfully removed in radical correction of the anomaly. The postoperative mortality in the group of patients without complications (5.6%) hardly differed from that among patients with unfavourable sequelae of the anastomosis (6.5%).

Adolescent↗
PubMed1990

[Results of the use of a graft with a monocusp in radical correction of Fallot's tetrad].

The article deals with the results of complex study of the effect of pulmonary insufficiency on intracardiac hemodynamics and function of the heart in the immediate and late-term periods after radical correction of Fallot's tetralogy. Answers are also given to questions concerning the expediency of the use and functional adequacy of a xeno-pericardial monocusp in the closure mechanism of the pulmonary artery valve. The study showed that massive pulmonary regurgitation has a negative effect on the functional condition of the right ventricle in late-term postoperative periods. Convincing data were obtained which allow a graft with a monocusp of a bull's pericardium to be recommended for further clinical use to prevent insufficiency of the pulmonary artery valve after radical correction of Fallot's tetralogy.

Animals↗
PubMed1985

[Surgical treatment of traumatic heart defects].

Data on surgical treatment of 6 patients with traumatic heart disease are reported. Accurate topical diagnosis is based on echocardiography, the catheterization of cardiac cavities and angiocardiography. The clinical course of the disease is dependent on the markedness of acute cardiac developments. Surgical strategy should be adjusted to each individual case, yet simultaneous correction of all heart defects must be sought in all cases. Where cardiac valves are damaged, valvular prostheses are the method of choice. Early and adequate surgical intervention results in rapid and complete recovery of the patient.

Adolescent↗
PubMed1979

[Problem of pulmonary hypertension in determining the indications for an operation in congenital heart defects].

The authors studied the indications for surgical treatment of patients with congenital heart diseases and increased pulmonary blood flow, depending on the degree of pulmonary hypertension. Particular attention is focused on the indications for operation in ventricular septal defect. The work is based on the experience of the workers of the institute, embracing 3,521 operations performed on this category of patients among whom there were 863 children under 3 years of age. The indications for surgery are determined in conformity with clinico-hemodynamic groups according to a classification elaborated at the institute. The late results studied in 213 patients in follow-up periods of up to 12 years show that the main evidence of the efficacy of surgical treatment are the hemodynamic data, which determine the prognosis and the subsequent working capacity of the patients.

Cardiac Surgical Procedures↗
PubMed1977

[Late results of the surgical treatment of interventricular septal defects].

The work deals with the following three problems: the criteria for the appraisal of the remote results; the evolution of pulmonary hypertension following correction of the defect; the indications for a repeated operation in reshunting. The examination was conducted on a group of 132 patients in postoperative periods of up to 13 years (5 years on the average) who had undergon surgery at the age of over 3 years. The analysis shows that the findings of clinical, electro-, phonocardiographic and X-ray examination are only of auxilliary importance as the criteria for the evaluation of the remote results. Changes in hemodynamics in remote periods after closure of the defect are the main indices of the efficacy of surgical management of patients with high pulmonary hypertension; it is just these changes that determine the prognosis. Considerable improvement in hemodynamics is revealed in most patients, which attests to the efficacy of surgery. In 29.2% of patients of the older age groups, however, mild or severe affection of the vessels of the pulmonary circulation was discovered. These data are an important argument in favour of early radical correction of the defect. In partial reshunting on the background of considerable improvement in hemodynamics and the general condition of the patient, one may refrain from carrying out an operation again and continue dynamik observation of the patient.

Adolescent↗
PubMed1976

[Evolution of pulmonary hypertension in the late period following correction of congenital heart defects].

The presented analysis is based on the data of haemodynamics studies in 62 congenital heart disease patients prior to and following surgery within 1 to 13 years (mean -- 5 years). Patent arterial duct ligation was performed in 34 cases, ventricular septal defect was closed in 28. Twenty of the patients had moderate, 42 -- high pulmonary hypertension (IIIa stage in 37 cases, IIIb stage -- in 5). Late postoperative haemodynamic studies have shown that Stage II patients demonstrated its normalization, the pulmonary artery pressure remaining above the normal level only in few cases in whom it had been 50 mm Hg and higher. In IIIa stage patients no normalization of haemodynamics is usually achieved, and in 9.1% of the cases an evolution of the total pulmonary resistance was noted. However, a distinct improvement of the haemodynamic parameters in the majority of such cases proves the efficacy of their urgical management. The persistence of high pulmonary hypertension or its progressive course in IIIb stage patients, caused by the spreading of the sclerotic process in the pulmonary vessles, indicates the inefficacy of surgery in this group of patients.

Adolescent↗
PubMed1975

[Spontaneous closure of the interventricular septal defects in children].

A total of 214 patients with a defect of the interventricular septum have been examined starting from the first days of their life and to the age of 7 years. In 50 of them the defect closed spontaneously (23.4 per cent). Twenty of these patients had a complicated course of the defect (circulatory insufficiency, colds and pneumonia). The spontaneous closure of the interventricular septum defect occurred most frequently at the age of from 1 to 4 years (86 per cent).

Age Factors↗