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M Iu Malyshev

Publications and source records attributed to M Iu Malyshev.

9 recordsLinked to original sources

[A comparative evaluation of myocardial protection based on criteria not associated with the quality of myocardial conservation].

Based on the rich clinical material (405 patients), the authors have assessed the most common blood and crystalloid cardioplegic techniques by applying the criteria which do not apply to those of myocardial protection adequacy. Differences have been found between the methods in the volumes of blood loss, the number of patients operated on without utilizing donor blood, terms of aortic occlusion at one-stage operative interventions, recovery of cardiac performance after aortic occlusion. The differences found are essential in choosing the type of cardioplegia by taking into account the individual traits of each surgical intervention and an operating surgeon's opinions.

Adult

[Massive arterial air embolism--a complication of heart surgery with extracorporeal circulation (clinical picture, prevention, treatment)].

Based on the literature data, the discussion covers the causes, preventive measures, and treatment of massive arterial air embolism, which is one of the most dangerous complications of artificial circulation (AC). Cerebral retroperfusion, hyperbaric oxygenation, low-temperature AC, and long-term administration of antihypoxic agents in the postoperative period have been considered most effective in the management of air embolism. The authors present their experience of successful management of four massive arterial air embolism cases, which is 0.22 percent of AC-assisted operations performed since 1984. Combined retrograde cerebral reperfusion and hypothermic AC have been used in the cases under discussion. Since it is impossible to determine the extent of embolism-associated brain damage and the limits of reliability of the applied therapy, it is essential in each embolism case to make use of all therapeutic means that are available in the given situation to combat this grave complication.

Cardiac Surgical Procedures

[Surgical correction of multivalvular defects in patients who had earlier undergone heart surgery].

The article analyses the results of surgical treatment of 45 patients with multivalvular acquired heart diseases which had been previously treated by operation. Stage III (terminal) circulatory disorders were diagnosed in 11 (24.1%) patients. A pathological condition of the tricuspid valve was found in almost all patients with the terminal stage of circulatory disorders. Eleven (24.4%) patients died after the operation. The most frequent causes of the fatal outcomes were: cardiac failure (in 6 patients) and hemorrhage (in 2 patients during the operation and in 1 patients on the 6th post-operative day; the bleeding occurred from varicose veins of the stomach and esophagus). Severe initial circulatory insufficiency was the main factor of operative risk. The criteria of operability must be elaborated for this contingent of patients suffering from severe cardiac insufficiency on the eve of the operation.

Adult