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Biomedical subjects

V A Bukharin

Publications and source records attributed to V A Bukharin.

At least 19 recordsLinked to original sources
PubMed1991

[Surgical treatment of congenital mitral valve insufficiency].

The experience of surgical treatment of 55 congenital mitral incompetence patients aged 3 to 34 years is analysed. Patients with the anomalies of the conotruncus, mitral stenosis, and open atrioventricular conduit were not included into the analysis. The preoperative clinical status of all the patients was evaluated as functional class III-IV. Twenty-one patients had attendant septal defects. Lung hypertension of group II was seen in 14 patients and of hemodynamic group IIIA in five patients. Pronounced disorders of intracardiac hemodynamics and circulatory impairments were indications to an operation. Failure of the mitral valve to close was secondary to several developmental defects. Deformities of the septa and of the chordal and papillary apparatus varied greatly. The mitral incompetence degree was aggravated in most patients by dilatation of the fibrous ring. The diversity of the morphological causes underlying mitral incompetence dictated a strictly individualized approach to the choice of the type and volume of a surgical intervention. Ten of the 55 patients underwent mitral valve replacement; various types of valvuloplasty were done to 45 patients. General hospital mortality rate was 10 percent; good and satisfactory outcomes were seen after reconstructive operations. Analysis of the outcomes of surgery for congenital mitral incompetence has shown that reconstructive operations on the valve are effective enough and may be recommended as a method of choice. Annuloplasty is required in most reconstructive procedures; in young children preference should be given to suture annuloplasty.

Adolescent↗
PubMed1990

[Origin of the aorta and pulmonary artery from the right ventricle].

In the period of 1980 to February 1988, 60 patients aged 1 year 7 months to 23.5 years were operated on for concordant atrioventricular linkage and origin of the aorta and pulmonary artery from the right ventricle. Sixty-two heart specimens were examined to study the defect anatomy. The left ventricular outlet opened up in the subaortic cone (Type A defect) in 47 (78.3%) patients, in the common subaortic and subpulmonary cone (Type B) in 8 (13.4%) patients, in the subpulmonary cone (Type C) in 3 (5%) patients; 2 (3.3%) subjects exhibited nonconcomitant ventricular septal defect (Type D). Thirty-four (56%) patients had pulmonary stenosis. Concomitant heart diseases were found in 78%. Fifteen patients (25%) underwent radical operation after prior palliative interventions. The total fatal cases were 13.7% (out of 58 operated patients, 8 died) in the group of radically operated patients. The fatal outcomes were observed in Type A defect. The analysis showed that defect correction techniques, age, prior palliative interventions, presence or absence of pulmonary stenosis, concurrent heart diseases, and restrictive ventricular septal defect failed to affect the immediate result of surgeries. An inaccurate preoperative diagnosis and lack of surgical experiment were factors increasing the risk for correction from 1980 to 1986. In the 2 years, the death rates decreased from 17.9% (7 dead patients per 39 operated ones) to 5.3% (1 dead patient per 19 radically operated ones).

Abnormalities, Multiple↗
PubMed1989

[Quantitative evaluation of hypoplasia of the heart ventricles and its significance for heart surgery].

The quantitative anatomy and morphology of hypoplastic ventricles were studied in 28 afflicted hearts (15 with left ventricular hypoplasia, 13 with right ventricular hypoplasia). The control comprised 10 normal heart specimens. All the 38 specimens were studied morphometrically; this was complemented with angiocardiometry and ventricular volume estimations in diagnosing right ventricular hypoplasia. Based on the study results, the morphometric criteria of ventricular hypoplasias and their variant forms were established. The linear characteristics were found to be informative enough both in hypoplasia diagnosis and in its degree assessment. To choose a therapeutic method, two degrees of right ventricular hypoplasia were distinguished. Radical correction aimed at eliminating concomitant conditions was found to be feasible and performed in 27 patients with moderate right ventricular hypoplasia.

Heart Defects, Congenital↗
PubMed1980

[Clinical hemodynamic classification of a secondary defect in the interatrial septum].

An interatrial septal defect is characterized by a diverse clinical course. The variability of the clinical picture of the defect is mainly due to the fact that it is encountered in persons of practically any age. The changes in the body of patients with this defect are determined by its duration. It is necessary to have a classification taking into account the specific clinical picture of the defect in order to assess the patient's condition. With this purpose in view the patient's condition is appraised according to the stages of the clinical changes and the degree of changes in pulmonary circulation. Such a classification will provide for proper consideration of the indications for surgical treatment, adequate preoperative management and appraisal of the late postoperative results.

Adolescent↗
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↗
PubMed1977

[Surgical treatment of solitary or common heart ventricle].

On the basis of 24 cases reported in the literature and 2 personal observations of the authors the indications for surgical correction of a single ventricle of the heart are discussed. Two different surgical techniques are described: 1) haemodynamic correction of the defect comprising a closure of the venous atrioventricular valve, oversewing the proximal pulmonary artery, and anastomosing the right atrium and the distal pulmonary artery; 2) radical correction--creation of the ventricular septum. The variants of the disease permitting a radical correction are indicated, the results of surgery, the causes of complications and mortality are discussed.

Angiocardiography↗
PubMed1977

[Hyperbaric oxygenation (current state and perspectives of its use in heart surgery)].

The current status of hyperbaric oxygenation (HBO) permits a preliminary determination of the optimum regimen with reference to the particular type of pathology to be treated and the method of treatment involved (surgery, resuscitation, therapy). The experimental section presents an analysis of the results of the combined effect of hyperbaric oxygenation and hypothermia, HBO and extracorporeal circulation. An extended series of experiments was conducted determining the optimum regimens of HBO in different types of hypoxia (circulatory, including cardiogenic shock, anemic, hypoxic). The clinical section presents the experience with HBO in 136 patients (118 cardiac procedures, and 18 emergency cases). The authors have the world's greatest experience with extracorporeal circulation under HBO. The priority is using this method for childbirth by women with severe heart diseases belongs to Soviet medicine. HBO was successfully used for the management of air embolism complicating openheart surgery.

Adolescent↗