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Biomedical subjects

V M Tkachenko

Publications and source records attributed to V M Tkachenko.

At least 19 recordsLinked to original sources
PubMed2004

[The performance of balloon Vater's ampulla dilatation in laparoscopic cholecystectomy as a method of choledocholithiasis treatment].

Experience of application of the antegrade balloon dilatation method for Vater's papilla sphincter during performance of laparoscopic cholecystectomy in patients with the gall-stone disease, complicated by choledocholithiasis, was presented. Short duration of hospital stay (5.5 days), low frequency of postoperative complications (4.5%), good late follow-up results witness the expediency of the method broad introduction into clinical practice.

Adult↗
PubMed1992

[The clinico-functional assessment and work capacity of patients undergoing repeated operations on the mitral valve].

A complex of examinations (ECG, echocardiographic and X-ray evaluations of heart volumes and cavities, treadmill-test) was performed in 82 patients before and after reoperations on the mitral valve. The type of recorrection was found to be associated with the degree of positive dynamics of the results. The data obtained contradicted to hyperdiagnoses of primary medical-labor examination commission establishing the II group of invalidism in 86 +/- 4% (M +/- m) of the examined patients. As a result of an analysis of all the data obtained the number of such patients was reduced up to 34 +/- 5%. A new approach to solving the problem of medical-labor examination was shown to be necessary for patients reoperated for mitral disease of the heart.

Adult↗
PubMed1990

[The characteristics of the myocardial morphofunctional status of hypothyroidism patients].

Electro- and echocardiography were used to examine the morphofunctional state of the heart in 19 patients with hypothyrosis during disease decompensation and after therapy with thyroid hormones. The hormonal blood content was measured by RIA. Nonspecific alterations of the electro- and echocardiographic readings characterizing hypothyroid myocardiodystrophy were discovered. Almost half of the cases manifested hydropericardium. The discovered myocardial alterations were marked by a slow positive dynamics. In patients over 45 years, they appeared irreversible in nature. The pericardial exudate resolved shortly after the euthyroid status was attained.

Adult↗
PubMed1989

[Work capacity of patients after resection of post-infarction heart aneurysm].

The paper provides data of a ten-year follow-up of 51 patients who underwent postinfarction left ventricular aneurysmectomy in the All-Union Surgery Research Center with a view to verifying the degree of working capacity loss. In the long-term period, out of them 37 persons (72.5%) had Group II disability, 10 (19.6%) had easier managerial jobs (4 persons (7.8%) had not worked before surgery) and 3 (5.9%) retired on their old-age pension. The surgical therapy for postinfarction cardiac aneurysm significantly improves the functional status and physical working capacity in 72.5% of the patients.

Adult↗
PubMed1987

[Myocardial contractile function of the left ventricle in patients with congenital stenosis of the ostium aortae].

A study of 61 patients with congenital stenosis of the aortic ostium has shown that left ventricular myocardial dysfunction is related to the extent of myocardial hypertrophy. Progressive discrepancy between growing left ventricular myocardial hypertrophy and its blood supply resulted, at a certain point, in a qualitative change from compensatory to abnormal hypertrophy. The extent of left ventricular hypertrophy determined the severity of aortic stenosis and left ventricular dysfunction. The emergence of electrocardiographic signs of left ventricular hypertrophy and systolic overstrain is indicative of the defect acquiring a new quality--that of left ventricular and relative coronary insufficiency.

Adolescent↗
PubMed1987

[Complex evaluation of the long-term results of resection of postinfarct aneurysms of the left ventricle].

Late results of left ventricular postinfarction aneurysm resection were studied in 112 patients. The results were good or satisfactory in 84.7% of patients, who mostly showed no hemodynamically significant coronary arterial stenoses or with one major branch affected, and a dyskinetic aneurysm. Clinical improvement was accompanied by a significant increase in stress tolerance, an increase in maximum oxygen utilization per 1 kg body weight, a decrease in the proportion of oxygen debt to oxygen want and better myocardial contractility, evidence of increased physical working capacity of the postoperative patients. The results were poor in patients with multiple coronary arterial stenoses and heart failure uncontrollable by medication.

Acute Disease↗
PubMed1987

[Factors determining the success of the surgical treatment of chronic postinfarct heart aneurysm].

Evaluation of instrumental findings in relation to clinical course of the early postoperative period in 105 patients operated on for chronic postinfarction aneurysm of the heart demonstrated that regional left-ventricular contractility, particularly that of unscarred myocardial tissue, is the principal determinant of surgical success, followed by the severity of attendant coronary sclerosis and, consequently, the adequacy of the chosen surgical procedure. Preoperative congestive heart failure, indicative of disrupted left-ventricular myocardial compensatory potential, is an aggravating factor.

Animals↗
PubMed1986

[Post-infarct cardiac aneurysm: clinical picture and contractile function of the myocardium in the remote period after surgical treatment].

Late results of surgery for chronic postinfarction aneurysm of the heart were reviewed in 48 patients. Comprehensive clinical and instrumental investigation demonstrated that aneurysm resection alone or in combination with aorto-coronary shunting or ventricular septoplasty resulted in clinical improvement in 60.4% of patients. However, surgery had basically no positive effect on left-ventricular myocardial contractility and pulmonary hemodynamics. The lack of positive changes in myocardial contractility is due to marked asynergy (akinesia) developing around the post-operative scar. The late postoperative outcome depends on both the type (akinetic or dyskinetic) of heart aneurysm, and timely referral for surgical treatment.

Adult↗
PubMed1986

[Segmental contractility and geometry of the left ventricle of patients with isolated lesions of the mitral valve].

Investigations showed that patients with "pure" stenosis of the left atrioventricular orifice as well as those with mitral insufficiency were characterized by left ventricular myocardial dysfunction expressed in a decrease of the index of left ventricular integral function--the ejection fraction and in change of geometry of the left ventricular cavity. Asynergy (hypokinesia) of the anterior wall segments and the posterior basal segment was revealed in patients with "pure" stenosis and "pure" mitral insufficiency. Hypokinesia in patients with primary mitral insufficiency was revealed in the anterior wall only. The above changes in the left ventricular segmental contractility can be regarded as a cause of left ventricular pump function disorder.

Adolescent↗
PubMed1985

[Myocardial function in the late period after an operation for aortocoronary shunting].

Thirty patients with coronary heart disease were examined prior to and 18.3 +/- 3 months after surgery, with 66% of the shunts proving to be patent. All patients were divided into 3 groups: group I--14 (47%) patients with patent shunts, group II--10 (33%) patients with partially patent shunts and group III--6 (20%) patients with occluded shunts. The group I and II patients displayed an improvement in the segmentary contractility and the integral function of the left ventricle as compared to the preoperative values. The group III patients showed a negative time-course of the segmentary and integral function of the left ventricle. In all cases of the impaired patency of the aortocoronary shunts there was progression of the atherosclerotic process in the basin of the shunted artery.

Adult↗
PubMed1985

[Clinico-hemodynamic correlations in patients with a postinfarct aneurysm of the left ventricle].

Eighty-four patients with left-ventricular post-infarction aneurysm were examined, 74 of those showing clinical signs of circulatory insufficiency. Selective coronarography and left roentgenocinematoventriculography were performed in all cases. Volumetric parameters and the ejection fraction were estimated for the total and contractile segment of the left ventricle. Statistical treatment of the data thus obtained demonstrated a relationship between the segmental contractility and manifestation of clinical signs of circulatory insufficiency. The limits were established for increments in residual and end-diastolic volumes that lead to the development of clinical manifestations of circulatory insufficiency. An increased end-diastolic pressure seems to be indicative of reduced elasticity (pliancy) of the left-ventricular myocardium, as reflected in markedly disturbed segmental contractility of the left-ventricular wall.

Adult↗
PubMed1985

[Evaluation of myocardial reserve in patients with post-infarction heart aneurysm].

The author examined 22 patients with postinfarction heart aneurysm to evaluate the myocardial reserves of the preserved myocardium with the use of the strophanthine test. The time-course of changes in the central hemodynamics, contractile function and segmental myocardial contractility of the left ventricle was evaluated. It was disclosed that the positive inotropic effect of strophanthine depends on the degree of the atherosclerotic lesions of the coronary arteries supplying blood to the zone of the preserved myocardium. In patients with postinfarction heart aneurysm and multiple demonstrable lesions of the coronary artery, administration of strophanthine brought about the deterioration of myocardial contractility of the left ventricle. No relationship was found between the initial status of the hemodynamics and the inotropic effect of strophanthine.

Adult↗
PubMed1985

[Non-invasive methods of examination in evaluation of cardiac reserve and contractile function of the myocardium in patients with postinfarct cardiac aneurysm].

Non-invasive diagnostic procedures (electrocardiography, spiroergometry, polycardiography) were compared with selective coronarography and left-side radioventriculography in 132 patients with chronic post-infarction aneurysm of the heart, in order to demonstrate their respective diagnostic values for the assessment of coronary and myocardial reserves of the heart. It was shown that physical stress tolerance, pO2max, the oxygen debt/oxygen requirement percentage ratio could be indicative of disturbed coronary reserve, while prolonged P wave and left-atrial deviation time, the number of abnormal Q and QS waves and increased resting myocardial contractility index (above 0.550) suggested impaired myocardial contractility.

Adult↗
PubMed1984

[Contractile function of the myocardium of the left ventricle in patients with isolated lesions of the aortic valve].

Seventy-five patients (aged 17-53) with an isolated lesion to the aortal valve have been examined. The study of correlations between clinico-instrumental and angiocardiographic findings has shown that the isotonic overload of the left ventricle as against the isometric one causes more pronounced changes in the contractility of the left ventricular myocardium which are expressed in an increased heart volume, the development of electrocardiographic manifestations of the left ventricular overload, a considerable enhancement in the myocardium weight and in the residual and end diastolic volumes of the left ventricle. The value of the gradient of the systolic pressure in patients with isolated aortal ostium stenosis determines the intensity of myocardial alterations. In patients with aortal valve insufficiency, the value of the pulse pressure is directly correlated with the myocardial state. The contractile function of the left ventricular myocardium in patients with combined cardiac aortal disease is dependent on the predominance of isotonic or isometric overloads of the left ventricle.

Adolescent↗