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Biomedical subjects

N K Gorianina

Publications and source records attributed to N K Gorianina.

At least 19 recordsLinked to original sources
PubMed1993

[Catheter balloon valvuloplasty in mitral stenosis (choice of surgical methods and evaluation of its results)].

Clinico-experimental study was undertaken for the choice of the optimal method for radiosurgical correction of the disease. Catheter balloon valvuloplasty (CBV), suggested by V. A. Silin and V. K. Sukhov with the use of balloon catheters of their design was found to be the most effective and safe method. This method was used to operate on 265 patients with mitral stenosis and various degree of affection of the valvular apparatus and complications in the form of calcinosis of the valve and cardiac fibrillation. Thirteen of the patients were operated on in pregnancy. CBV produced a positive therapeutic effect in more than 95% of patients. Increase of the mitral orifice area by 2.2-3.4 times was attended by a corresponding reduction of the diastolic pressure gradient at the mitral valve and systolic pressure in the pulmonary artery. The increase in the area of the mitral orifice and the positive changes of the hemodynamics values were more marked in patients with severe stenosis. The small number of complications (up to 9.5%) and the low lethality (up to 0.86%) allow the CBV method to be recommended as one of the main methods of surgical correction of mitral stenosis.

Adult↗
PubMed1991

[Catheterized balloon mitral valvuloplasty in pregnancy].

Catheterized balloon mitral valvuloplasty was carried out in two females with rheumatic mitral stenosis on the 28th and 24th weeks of pregnancy. The operation on the first patient was performed at the beginning of the development of pulmonary edema. Treatment produced good results in both cases. The surface of the mitral orifice increased from 1.5 and 1.6 to 3.2 and 3.5 cm2, the pressure gradient between the left atrium and left ventricle reduced from 40 and 30 to 6 and 4 mm Hg. There was attended by disappearance of the diastolic murmur and the clinical manifestations of congestion in pulmonary circulation in both patients. Mitral regurgitation did not occur after the operation. Radioscopy lasted 20 and 33 minutes. Protective screens were used to protect the fetus from direct exposure to X-ray. Pregnancy terminated at full term by spontaneous delivery in both patients. The babies, both girls, are healthy. Catheterized balloon mitral valvuloplasty does not yield to closed mitral commissurotomy in efficacy. The mild character of injury inflicted during the operation and no need for general anesthesia make this intervention most preferable in female patients with mitral stenosis during pregnancy.

Adult↗
PubMed1991

[Catheter-balloon valvuloplasty in mitral valve stenosis (selection of the method of procedure, immediate results and the criteria of patient selection].

Catheter-balloon valvuloplasty (CBV) was carried out in 80 patients with rheumatic mitral stenosis, whose ages ranged from 22 to 68 years. Seventeen of these patients were operated on for mitral valve restenosis; I-II degree calcinosis of the mitral valve was revealed in 18 patients; seven women underwent surgery in the 24th-32nd week of pregnancy. After applying various methods (19 cases) the authors used in the last series of operations (61 cases) the Silin-Sukhov method using an original dilatation catheter with a balloon measuring in diameter up to 34 mm, which allowed pressure of up to 8 atm. to be produced during a working cycle no longer than 8 sec. As the result of CBV, the area of the mitral orifice was enlarged by no less than twice in all patients, the pressure gradient through the mitral valve and systolic pressure in the pulmonary artery reduced. The total number of complications which called for operative treatment was 3.75%. CBV is a still developing method, but already today it may be considered the method of choice in the treatment of uncomplicated forms of mitral stenosis, in I-II degree calcinosis, and when the risk of the traditional surgical intervention on the heart is increased.

Adult↗
PubMed1991

[Treatment of mitral valve stenosis in pregnant women by the method of balloon valvuloplasty].

Catheter-balloon mitral valvuloplasty was performed in 7 females with rheumatic mitral stenosis on the 19th-32nd week of pregnancy. Four patients were operated on with signs of cardiac insufficiency, two--in a state of pulmonary pre-edema. Edema of the lungs in one patient continued developing on the operating table. The results of the treatment were good in all cases. The area of the mitral orifice increased from 0.9-1.75 to 2.4-3.5 cm2. The pressure gradient between the left atrium and the left ventricle dropped from 25-40 to 2-8 mm Hg. This was attended by the disappearance of the diastolic murmur and the clinical manifestations of stasis in pulmonary circulation in all patients. The development of mitral regurgitation after the operation was not encountered in any of the patients. The period of roentgenoscopy lasted 17.5 min. on the average. Screens were used to protect the fetus from the direct effect of the X-rays. Pregnancy ended in delivery in 6 patients; spontaneous labor at term occurred in 4, cesarean section had to be performed in one patient with placenta previa; one woman gave birth to twins on the 36th week of pregnancy. All the babies were healthy. Catheter-balloon valvulotomy does not yield to closed mitral commissurotomy in efficacy. The fact that it is only mildly injurious and does not need general anesthesia make this intervention preferable for pregnant women suffering from mitral stenosis.

Adult↗
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↗
PubMed1988

[Surgical correction of rupture of aneurysm of the sinus of Valsalva].

Operations were performed on 48 patients with aneurysms of the thoracic aorta, one of them had a rupture of aneurysm of the noncoronary sinus followed by the formation of a fistula between the aorta and the right atrium. The fistula was ligated by an access through the right atrium with good nearest and long-term results.

Adult↗
PubMed1985

[Diagnosis of aortic valve calcinosis with a view to the surgical treatment of aortic valve disease].

Combined roentgenologic/echocardiographic diagnosis of aortic valve calcinosis was made in 135 patients operated on for a rheumatic aortic heart disease. Four degrees of aortic valve calcinosis were identified: 1) isolated fine points of calcinosis, as revealed by echolocation and specific treatment of the removed valves; 2) small-focal calcinosis as revealed roentgenologically in 79.2% of cases and by echolocation, in 93%; 3) large-focal, and 4) wide-spread calcinosis, the latter two being detectable both roentgenologically and echocardiographically in all cases. The 4-degree classification of aortic valvular lesions allows a detailed assessment of the nature of the affection that is important for the choice of surgical procedure.

Aortic Valve↗
PubMed1977

[Effect of the respiratory phases on the right jugular vein pulsation curve and pulmonary hemodynamics in mitral valve stenosis].

In patients with mitral stenosis the main and early changes in the pulsation curve of the right jugular vein consist in an elevation of the y-collapse. The height of the y-collapse correlates with the degree of venous congestion in the lungs, i.e. a parallelism exists between the signs of venous congestion in the pulmonary and general circulation systems. The degree of venous congestion in the lungs of patients with mitral stenosis varies with the phases of respiration. An elevation of the v-collapse in mitral stenosis cases is observed at early stages of the disease, simultaneously with the disorders in venous circulation in the upper lobes. The mechanism of circulatory disorders in the veins of the general circulation system may be due to not only pulmonary hypertension and right ventricular insufficiency, but also to the changes in the intrathoracic pressure secondary to the changes in pulmonary parenchyma.

Hemodynamics↗
PubMedDate not supplied

[Balloon catheter mitral valvuloplasty in pregnant women].

Catheter balloon mitral valvulotomy was performed in two patients with rheumatic mitral stenosis on the 28th and 24th weeks of pregnancy. The operation in the first patient was carried out at the onset of pulmonary edema. The results of treatment were good in both cases. The area of the mitral orifice in the patients increased from 1.5 and 1.6 to 3.2 and 3.5 cm2, the pressure gradient between the left atrium and the left ventricle reduced from 40 and 30 to 6 and 4 mm Hg. This was attended by disappearance of diastolic murmur and clinical manifestations of pulmonary congestion in both patients. Mitral regurgitation did not develop after the operation. Roentgenoscopy lasted 20 and 33 minutes. Screens were used to protect the fetus from the direct effect of X-rays. Pregnancy terminated in both patients by spontaneous at term delivery. They gave birth to two healthy girls. Catheter balloon mitral valvuloplasty does not yield to closed mitral commissurotomy in efficacy. Due to its low traumatizing property and no need for general anesthesia this intervention is preferable for pregnant females suffering from mitral stenosis.

Adult↗