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Biomedical subjects

M L Semenovskiĭ

Publications and source records attributed to M L Semenovskiĭ.

At least 19 recordsLinked to original sources
PubMed1992

[Cellular mechanisms of impaired cardiac energetics in patients with dilated cardiomyopathy: decrease in mitochondrial respiration and creatine kinase expression].

The mitochondrial functional characteristics were assessed in the biopsy specimens from patients with various Functional Classes dilated cardiomyopathy (DCMP). The assessment was made by using endomyocardial biopsy specimens weighing 2-4 mg which had been taken from 39 patients aged 19-64 years during coronary ventriculography and cardiac transplantation. The status of mitochondria and the efficiency of mitochondrial creatine kinase functioning were evaluated by recording the respiration of saponin-skinned muscular fibers. The maximum mitochondrial respiration rate calculated on a dry weight basis was not substantially different in all functional classes of DCMP, while the acceptor control index (Vmax/V0) and the level of creatine-activated respiration decreased with an increase in the functional class of DCMP. The findings show a good positive correlation between ejection fraction and creatine-stimulated respiration values and a linear negative correlation between this parameter and end-diastolic pressures. Thus, the respiratory parameters of mitochondria in the endomyocardial biopsy specimens may be used to assess the severity of cardias lesions.

Adult↗
PubMed1991

[Surgical treatment of ascending aorta aneurysm combined with aortic valve insufficiency].

The article deals with the immediate and late-term results of surgical management of aneurysm of the ascending aorta with aortic incompetence in 33 patients, on whom 34 operations were conducted. The etiology, diagnosis of the disease, and the main moments of the surgical techniques are discussed. For the solution of surgical problems, setting apart patients with dyshistogenetic predisposition is suggested. Among the instrumental methods of examination preference was given to radiocontrast aortography and magneto-resonance tomography. The last named is preferable because it is noninvasive, highly informative, and specific. The choice of the method was determined by the existence of stratification and the level of the orifices of the coronary arteries above the fibrous ring. The conduit was wrapped in the remnants of the aneurysmatic sac in all cases; the approach to the formation of the communication between the last named and the right atrium was differentiated. The central moment of the reconstruction is the formation of the distal anastomosis of the conduit with the aorta in stratification. In the late-term postoperative periods particular attention was paid to patients with dyshistogenetic predisposition because of the possible spreading of stratification to the distal parts of the aorta.

Adolescent↗
PubMed1990

[Ultrastructural characteristics of anti-ischemia protection of intact and hypertrophic myocardium with phosphocreatinine].

Ultrastructural changes in normal and hypertrophied dog hearts under conditions of total ischemia were studied by electron microscope method. In the control group sings of irreversible damage appeared in 90 min, in the presence of phosphocreatine, 10 mM, these changes became apparent in 120 min. In the hypertrophied hearts signs of the irreversible damages became evident in 60 and 90 min in the absence and presence of phosphocreatine, respectively. Ability of phosphocreatine to protect both normal and hypertrophied myocardium allows to use it safely.

Animals↗
PubMed1990

[The first clinical experience with heart transplantation].

The article analyses the first clinical experience in orthotopic allotransplantation of the heart at the Scientific Research Institute of Transplantology and Artificial Organs, USSR Ministry of Health, in the period from October, 1986 to July, 1989 (26 transplantations of the heart and one two-stage transplantation of the heart with the use of "Poisk-10M" artificial heart for 3.5 days in the first stage). Eleven patients are alive. Follow-up periods: maximum over 2.5 years, minimum 3 months. Sixteen patients died in different periods (up to 12 months). Three-component therapy (cyclosporine A, methylprednisolone, azathioprine) was applied for immunosuppression. The authors analyse the problems of the selection of potential recipients (indications and contraindications) and donor, the optimum surgical techniques, complications of immunosuppressive therapy, and infectious complications. The first clinical experience in two-stage transplantation of the heart is analysed. The first experience in transplantation of the heart in patients allows the conclusion that the use of this method for the management of the terminal stage of congestive cardiac insufficiency is a reality.

Adult↗
PubMed1990

[Hemodynamic evaluation of the effectiveness of preservation of subvalvular structures in mitral valve prosthesis].

The article deals with the clinical evaluation of the results of mitral valve prosthetics with preservation of the subvalvular structures in 40 patients and comparative evaluation of the hemodynamic indices after prosthetics with preservation of the subvalvular structures of the posterior cusp and after routine mitral valve prosthetics. The authors show good clinical results in patients after valvar-preserving prosthetics of the mitral valve and essential improvement of left-ventricular contractile activity after such an operation. Comparative analysis showed that the total ejection fraction increased by 10.8 +/- 4.5% in the main group and reduced by 11.4 +/- 2.6% (p less than 0.01) in the control group. Left-ventricular end diastolic pressure did not change in the main group but increased significantly (p less than 0.05) in the control group. A conclusion is drawn that preservation of the subvalvular structures in mitral valve prosthetics is expedient even in patients with an initially grave condition because the method makes it possible to normalize intracardiac hemodynamics more rapidly in the postoperative period and essentially improve the contractility of the left ventricle.

Heart Valve Prosthesis↗
PubMed1990

[Retrograde cardioplegia through the right atrium].

The results of retrograde cardioplegia through the right atrium in 50 patients are analysed. The uniform cooling of the myocardium, frequent restoration of the sinus rhythm, and the low hospital mortality rate are evidence of the high efficacy of this method of myocardial protection. Electronmicroscopy showed marked intactness of the myocardial ultrastructure and moderately manifested and reparable reperfusion changes. It is concluded that the method must be employed in coronary disease, combination of ischemic heart disease with heart valvular disease, as well as in mild forms of aortic insufficiency which cannot be corrected.

Adolescent↗
PubMed1990

[Optimal conditions for preservation of isolated heart using creatine phosphate and vitamin E (an experimental study)].

Functional and structural safety of the myocardium following 6-hour preservation at 4-6 degrees C in ion-balanced cardioplegic solution alone or in combination with pharmacological corrective was evaluated in rats. Langendorff and Neely model of isolated heart perfusion was used. The addition of creatine phosphate in a conservation of 10 mM/l to the solution or donor pretreatment with 70 mg/kg vitamin E was found to potentiate the protective properties of the solution under deep hypothermia. The combined use of the agents proved to warrant the initial intact structural and functional status of the rat myocardium.

Animals↗
PubMed1987

[Late results of aortic valve prosthesis (a clinico-hemodynamic analysis)].

Long-term results of aortic-valve ball prosthesis implantation in 184 patients, followed up for about 15 years, are presented. The performance of Soviet-made ball prosthesis in the aortic position has been shown to be fairly satisfactory for a long time. Prostheses of this design are also highly wear-resistant and show satisfactory hydrodynamic properties.

Adult↗
PubMed1985

[Structural and biochemical characteristics of the effectiveness of intraoperative protection of the myocardium].

Results of morphological and biochemical examination of 153 myocardium biopsies from 42 patients with the intraoperational heart ischemia that developed during the correction of cardiac valves disturbances under the condition of artificial circulation and cardioplegia with the blood based solution are given. Phosphocreatin ("neoton" produced by Schiapparelli Company, Italy) was added as a cardioprotector to the cardioplegic solution in 24 patients. The high efficiency of the drugs for the cardiomyocytes sarcolemma is shown by means of colloidal lanthanum. A full retention of the macroergic phosphates is also shown biochemically when the standard solution was modified for the heart protection.

Adenosine Triphosphate↗
PubMed1984

[Use of balloon catheters for intraoperative control of resting myocardial pressure during cardioplegia].

Twenty-two patients operated on for aortal, mitral and multivalvular prosthesis under pharmacological cardioplegia were examined for the purpose of monitoring myocardial resting tension by the tensometric method and by using modified balloon catheters. The results demonstrated that the use of the balloon catheters permits making not only qualitative and quantitative assessments of myocardial lesions and a prompt evaluation of the function of the arrested heart but also the initial myocardial contractility and the restoration of myocardial contractility after cardioplegic arrest by controlling the contraction and relaxation myocardial rate.

Cardiac Catheterization↗
PubMed1983

[Evaluation of patient rehabilitation effectiveness after aortic valve prosthesis based on spiroergometric study data].

Patients after surgery introducing aortal valve prosthesis in cases of rheumatic aortal defect or defect due to bacterial endocarditis were examined using spiro- and bicycle ergometry. Two groups of patients were compared: those subjected to rehabilitation procedures and a control group undergoing no rehabilitation program. Functional results were better in post-rehabilitation patients. By the end of the rehabilitation program, the examined spiroergometric parameters were significantly closer to those of normal subjects, as compared to the controls. Spiroergometric investigation in patients with newly applied aortal valve prostheses supplements clinical data in providing a more profound functional evaluation of surgical results and rehabilitation efficiency.

Adult↗
PubMed1980

[Surgical procedure in repeated operations on the mitral valve].

The experience in repeated operations on the mitral valve is generalized and the results of 340 repeated closed mitral commissurotomies and 124 operations performed under conditions of extracorporeal circulation are analysed. Hospital mortality in open operations is still rather high (20%), whereas the stability of good results in follow-up periods of up to 5 years is 53.9%. At the same time, the results of repeated closed operations are quite acceptable; low hospital mortality (4.7%), relatively satisfactory stability of good results (55.3% in follow-up periods of up to 10 years). The authors believe that a differentiated approach to the choice of the method for repated operations on the mitral valve is necessary.

Extracorporeal Circulation↗
PubMed1979

[Valve prosthesis in calcified aortic heart defects].

Experience in surgical correction of aortic valvular disease with extreme calcification of valves in 145 patients is generalized. The method for valve prosthetics preventing the development of specific complications is described. On the basis of analysis of the immediate and late postoperative results, it is recommended to use cold cardioplagia for protection of the myocardium. Hospital postoperative mortality was 13.9% in the last 4 years and 10.5% in the last 18 months. Preliminaly coronarography is suggested for the examination of patients with marked angina pectoris and with local changes on the ECG in the group of elderly patients for ruling out a concomitant organic lesion of the coronary artery.

Adolescent↗