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V N Il'in

Publications and source records attributed to V N Il'in.

At least 19 recordsLinked to original sources
PubMed2005

[Diagnostic algorithms and features of clinical course of congenital heart diseases in infants with lung anomalies].

The paper discusses the influence of lung anomalies on the progress of congenital heart diseases (CHD) in infants, as well as diagnostic value of radiography and ultraspeed computed tomography (CT). The four-year experience of the authors includes preoperative examination of 178 infants with CHD (mean age 5.8 +/- 0.6 months, mean weight 5.2 +/- 0.3 kg). Lung anomalies were determined in 24 patients (13.5%) on plain films and in 85 patients (47.8%)--by means of CT. The stenosis of main bronchi in combination with lobar emphysema and lung hypoplasia were found to be the most frequent and severe predictors of respiratory disorders. The obtained data suggest that CT examination may be recommended in infants with CHD for precise diagnostics of associated lung anomalies and further prevention or early management of respiratory complications.

Abnormalities, Multiple↗
PubMed2005

[Urgent surgical correction of ventricular septal defects in children of first months of life].

The article presents the results of urgent surgical correction of ventricular septal defects (VSDs) and a range of associated congenital heart diseases (CHDs) in 123 children of the first 6 months of life, hospitalized between 1988 and 2002 in a severe or critical condition. In 102 patients the progression of clinical symptoms was caused by a big single VSD and in 21 patients--by multiple VSDs. 70 patients had significant associated CHDs. Significant extracardiac anomalies were revealed in 75 patients. The condition of 55.3% of children had deteriorated due to pneumonia. Correction of defects with cardiopulmonary bypass was performed after urgent examination and intensive therapy. Hemodynamically significant VSD were closed in 117 (95.2%) patients. Two patients were reoperatied due to the presence of residual VSD. Partial or full simultaneous correction of associated CHDs was performed in 68 patients. 93.5% of patients with isolated VSDs survived the operation. The survival rate of patients with associated CHDs and extracardiac anomalies was 81.5%. Postoperative mortality risk factors were found to be critical condition at hospitalization and preoperative activity of infectious process (P < 0.01 and < 0.05, respectively). Accumulation of experience and introduction of a special approach allowed an 8-time decrease of the hospital mortality, which has not exceeded 3.4% within last 3 years. Good and excellent follow-up results were obtained in 98% of the survived patients within 10 to 67 months after operation. Precise diagnostics of associated CHDs and extracardiac anomalies, intensive preoperative treatment and weighed estimation of indications and risk factors allow significant improvement in the results of primary correction of VSD and accompanying cardiovascular anomalies in children of the first months of life in a heavy and critical condition upon admission.

Cardiac Surgical Procedures↗
PubMed1992

[The use of polytetrafluoroethylene vascular prostheses (Gore-Tex) for subclavian-pulmonary anastomosis in children with tetralogy of Fallot].

The paper provides the results of a modified subclavian pulmonary anastomosis by employing Gore-Tex vascular prostheses in 91 babies with Fallot's tetrad whose age was 10 days to 32 months and weight was 3.6 to 15 kg. In 89 patients, the operation was performed by using a prosthesis, 4-6 mm in diameter, without crossing the subclavian artery, whereas in 2 patients, this was done by lengthening the crossed short subclavian artery. In the early postoperative period, 2 (2.2%) patients died, anastomosis thrombosis requiring a reoperation, occurred in 3 (3.3%) patients; other non-fatal complications were observed in 8 (8.8%) patients. A clear-cut effect of the operation was seen in all patients. SaO2 rose from 54 +/- 18 to 80.0 +/- 8%. In the long-term (6-60 months) postoperative periods, a total of 77 patients were examined: anastomosis function proved to be impaired in 4 (5.2%), all the vascular prostheses, 6 mm in diameter, were patent up to 60 months of surgery. The thrombosis probability for anastomosis, 5 mm in diameter, was 5% during 12 months of operation and 16% during 24-60 months. Three patients needed therapeutical management of heart failure. Other serious complications, including deformity of the pulmonary artery or upper extremity, were not found in the examinees. In the palliative treatment of Fallot's tetrad, subclavian pulmonary anastomosis via the Gore-Tex vascular prosthesis can be the method of choice in the first-year-old infants and has some substantial advantages over the classical Blelock-Taussig anastomosis.

Blood Vessel Prosthesis↗
PubMed1992

[The treatment of critical valvular stenosis of the pulmonary artery by the balloon valvuloplasty method in patients in the first 3 years of life].

The work generalizes the experience of the Bakulev Institute of Cardiovascular Surgery in balloon valvuloplasty of valvular pulmonary stenosis in 58 children of the first 3 years of life: 8 were 1 to 6 months of age, 10 were 7 to 12 months of age, 18 were 13 to 24 months old, and 22 were 25 to 36 months old. Cyanosis was found in 27 of them. As the result of balloon valvuloplasty, the systolic pressure gradient between the right ventricle and the pulmonary artery reduced from 114.7 +/- 12.6 to 31.4 +/- 7.2 mm Hg in children under 1 year of age, from 143 +/- 12.6 to 40.1 +/- 8.3 mm Hg in children aged from 1 to 3 years. In patients with cyanosis, saturation of arterial blood with oxygen increased to 92%. The late-term results were studied in follow-up periods of 6 to 36 months in 35 patients, by means of catheterization and angiocardiography in 15 of them. Analysis showed balloon valvuloplasty to be effective. Balloon valvuloplasty was repeated in 5 patients with critical stenosis because a hemodynamic effect was not achieved by the first dilatation.

Catheterization↗
PubMed1992

[The results of the surgical treatment of aortic coarctation in nursing infants with a sharp decrease in left ventricular pumping function].

Two-dimensional echocardiography was conducted in 24 patients, aged from 14 days to 12 months, suffering from coarctation of the aorta (CA) with the left ventricular (LV) ejection fraction (EF) less than 30%. The symptom of LV fibroelastosis was found in only 16.7% of patients. In the first 7 days after correction of CA the LV end-systolic volume reduced by 20% and the EF increased by 1.5 times, which may be explained by removal of LV post-loading. The values of the LV pumping function improved in the late periods due to restoration of myocardial contractility. In infants operated on in the first 3 months of life the dynamics was more favorable, the EF reached 68 +/- 3.8% while in those operated on after the age of 3 months it reached only 50.8 +/- 2.5% (p < 0.05). The authors discuss problems of compensatory hypertrophy and myocardial contractile capacity as the main mechanisms responsible for LV pumping function in CA.

Aortic Coarctation↗
PubMed1990

[Initial experience in the correction of the tetralogy of Fallot in infants using an approach through the right atrium and the pulmonary artery].

Radical correction of Fallot's tetralogy by means of an approach through the right atrium and pulmonary artery without ventriculotomy (10 patients) or with minimal ventriculotomy (23 patients) was carried out in children whose ages ranged from 13 to 50 months and body weight from 7.9 to 15 kg. Lethality was 12%. The death of 3 patients was not connected with the peculiarities of the surgical tactics, the death of the fourth patient was due to insufficient experience in development of the surgical techniques of the first operations. The operative techniques applied are described in detail and the possibility of adequate correction of Fallot's tetralogy by it is proved principally. The late-term operative results are good in 10 patients. The first results of the suggested method of surgical correction of the anomaly are claimed by the authors to be promising, which allows them to continue its further elaboration.

Child, Preschool↗
PubMed1990

[Radical correction of tetralogy of Fallot in infants under 1 year of age].

The article generalizes the experience in surgical treatment of Fallot's tetrad in 20 infants. Radical correction of the anomaly was carried out under extracorporeal circulation and deep hypothermia with reduced volume rate of perfusion. Plastics of the conus arteriosus alone was performed in 6 patients, transanulus and the pulmonary trunk in 4 patients. Two patients died, the hospital lethality was 10%. A clinical effect was produced in all the other patients. The relation of systolic pressure in the left ventricle to that in the right ventricle was 0.56 +/- 0.1, the systolic pressure gradient between the right ventricle and the pulmonary artery was 18 +/- 4.2 mm Hg. Various degree of regurgitation at the pulmonary valve was revealed after the operation in all patients. It was maximum (34 +/- 10%) in transanulus plastics.

Age Factors↗
PubMed1990

[Surgical treatment of patients with tetralogy of Fallot in combination with a double aortic arch].

A late congenital anomaly--double arch of the aorta (DAA)--was combined with Fallot's tetrad (FT) in 4 patients whose ages ranged from 21 months to 11 years. The diagnosis of DAA and FT was established before the operation in 3 patients, in one patient DAA was discovered during the operation. In three children DAA was manifested clinically by dysphagia and stridor. A palliative operation (FT) was carried out through a left posterolateral approach along the third intercostal space. One-stage separation of the vascular ring by cutting the smaller left arch of the aorta at its junction with the descending aorta and formation of anastomosis between this arch and the left pulmonary artery by the end to side method were conducted. In deficient length of the cut arch of the aorta the left subclavian artery was divided; in equal diameter of both arches the lumen of the arch was reduced to 0.5 cm with stitches before formation of the anastomosis so as to prevent hyperfunction of the shunt. In the case in which DAA was not recognized before the operation, an attempt to dilate the hypoplastic segment of the left arch led to rupture of the thinned wall and the patient died from hemorrhage. The advantages of one- and two-stage radical correction of both developmental anomalies (DAA and FT) are still debatable.

Abnormalities, Multiple↗
PubMed1990

[Changes in cardiac hemodynamics, volume and pumping function of the heart ventricles in natural course of Fallot's tetrad].

The work analyses the results of repeated clinical and intracardiac examination of 13 patients with tetralogy of Fallot, conducted at the age of 23.1 +/- 9.9 and 42.3 +/- 13.1 months. The severity of the clinical condition grew markedly during natural course of tetralogy of Fallot (TF): the SaO2 value reduced from 71.8 +/- 7.2 to 65.0 +/- 8.0% and the blood hemoglobin level grew from 165 +/- 28 to 194 +/- 30 g/l. The data presented are evidence that in TF following a natural course a distinct tendency is displayed to growth of end diastolic volume of both ventricles in relation to the normal value and their dysfunction progresses in the form of reduction of the ejection fraction and increase of right-ventricular diastolic "rigidity". The results of the present work may be considered a substantiation of the tactics of early TF correction in infants and young children before the development of serious morphological changes and functional disorders.

Cardiac Volume↗
PubMed1990

[Effects of the Blalock-Taussig operation on the development of the pulmonary artery in patients with tetralogy of Fallot].

The effect of the Blalock-Taussig operation on the growth of the pulmonary arteries (PA) in infants with tetralogy of Fallot (TF) was studied in late-term periods. Thirty-eight patients were examined, angiography and study of hemodynamics were conducted 31 to 144 months after the Blalock-Taussig operation. The obtained data provide evidence that as the result of the operation all segments of the hypoplastic PA grew to such a size that radical correction of the anomaly could be accomplished. In patients with an initially normal size of the PA growth of the vessel was not encountered. Iatrogenic complications and deformities of the PA occurred in 13.2% of cases. These complications developed most frequently (7.9%) in patients in whom the anastomosis was established in the first year of life. The degree of severity of the infundibular stenosis grew in all patients. Severe obstruction of outflow from the right ventricle developed in 10.5% of patients; in 7.9% of children it was completely obstructed. In view of that prolonged delay of the second stage of surgical treatment is inexpedient.

Age Factors↗
PubMed1989

[Experience in the use of the Mustard operation in the surgical treatment of transposition of the great vessels].

In the 1980-1988 period, Mustard's operation was used to treat transposition of great vessels at the Department of Younger Children, A. N. Bakulev Institute of Cardiovascular Surgery. Seventy nine patients were operated on: 56 with simple transposition, 9 (16%) patients died; 23 with complex transpositions of great vessels (18 with concurrent ventricular septum defect, 5 with Taussig-Bing's disease), 5 (22%) patients died. Rhythm disturbances and obstruction of the venae cavae were most common postoperative complications. Six patients underwent Mustard's operation with closure of ventricular septal defect. In 18 patients this operation was performed as a palliative procedure due to high pulmonary hypertension. Lung biopsy showed the majority of patients with concurrent transposition and interventricular septal defect to have grade III-IV changes (by Hit-Edwards' classification) in the pulmonary vessels. Long-term hemodynamic studies showed good effect of palliative Mustard's operation.

Child↗