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Biomedical subjects

V S Shchukin

Publications and source records attributed to V S Shchukin.

14 recordsLinked to original sources
PubMed1991

[Effect of various factors on the lungs after operations with non-perfusion hypothermia].

Correction of the acquired defect of the mitral valve was performed in 89 patients on the open heart under conditions of nonperfusion hypothermia. Roentgenological assessment of the lung state was used in the postoperative period. Typical morphofunctional alterations were detected after operations under conditions of nonperfusion hypothermia. It was found that the increased volume of +blood transfusions more than 19 ml/kg of the patient's body weight was followed by a reliably increased frequency and degree of ++roentgenological symptoms of injuries of the lungs.

Adult↗
PubMed1991

[Methods to decrease the blood loss during operations under hypothermia without perfusion].

The work analyzes causes of high blood loss in operations under conditions of nonperfusion deep hypothermia. It was found to be related with the division of massive adhesions in the preocclusive period and with the presence of prolonged heparinemia after occlusion. A combination of a minimal trauma of adhesions, reliable surgical hemostasis, early suturing the wound of the chest and early neutralization of activity of heparin allowed the operation blood loss to be 2.4 times less and the postoperative blood loss--2.7 times less.

Blood Loss, Surgical↗
PubMed1991

[Reconstructive operations in mitral insufficiency under whole-body hypothermia (27-25 degrees C) without perfusion].

The article discusses the results of reconstructive valve-preserving operations in mitral insufficiency performed under conditions of hypothermic (27-25 degrees C) protection without perfusion in 114 patients. Depending on the valve morphological changes multicomponent intervention was under taken contemplating the performance of commissurotomy, chorda fenestration, resection and sewing of the cusps, removal of fibrous deposits from the cusps, resection of peripheral and intermediate chordae. The discrepancy between the cusp area and the perimeter of the fibrous ring was corrected in 99 patients by annuloplasty with sutures. The hospital mortality was 6.1%. Six-year postoperative survival was recorded in 91% of cases; no thromboembolic complications encountered in 97.4% of patients. The condition improved in most patients and they moved to NYHA Functional Class I-II. Unfavourable results were due to a severe initial clinical and functional condition and to the operations conducted in the active stage of septic endocarditis.

Adult↗
PubMed1990

[Pathological sequelae of blood transfusion during hypothermia].

Under analysis was the influence of two factors--blood loss (intraoperative and postoperative) and blood substitution--upon the frequency of postoperative complications in patients with acquired mitral heart diseases operated upon under conditions of non-perfusion hypothermia. A conclusion is made that hemotransfusion during operations performed under conditions of "dry" heart and non-perfusion hypothermia should be performed but in anemia threatening by hemic hypoxia.

Blood Volume↗
PubMed1990

[Differences in the ultrastructural reorganization of the myocytes of the atria and ventricles in the stages of the correction of mitral heart defects].

Ultrastructure and stereomorphometry of the myocardium biopsies from 12 patients are studied at various periods of the correction of mitral vitium cordis under the conditions of total body hypothermia. It is shown that compensatory changes enhance the morphological differences between the left atrium cardiomyocytes in stenosis of the mitral aperture and those in left ventricle in deficiency of mitral valve. By the end of operation the ventricle cardiomyocytes are damaged at a higher degree showing the pronounced myofibrillary contracture. The atrium myocytes having a labile protein-synthetic apparatus are more resistant to the damaging effect of operation. Morphofunctional specialization of different heart compartments should be taken into consideration in diagnostic practice.

Adult↗
PubMed1989

[Emergency correction of traumatic mitral valve insufficiency under craniocerebral hypothermia].

Data of emergency correction of traumatic mitral insufficiency in 15 patients after closed mitral commissurotomy under conditions of craniocerebral hypothermia without artificial blood circulation are presented. Prostheses of the mitral valve were made in 3 patients, plastic valve-preserving interventions--in 12 patients. One patient died. The authors consider that in most cases with traumatic insufficiency of the mitral valve after closed commissurotomy it is possible to perform valve-preserving operations, craniocerebral hypothermia being a reliable method of their maintenance.

Adult↗
PubMed1989

[Ultrastructure of cardiomyocytes during mitral valve replacement in non-perfusion hypothermia].

The ultrastructure of biopsy specimens obtained from the left ventricle was examined at varying stages of mitral valve replacement under non-perfusion hypothermal protection (at 27-28 degrees C). In patients with clinical stage IV mitral incompetence, cardiomyocytes were shown to combine signs of marked hypertrophy and decompensation. Despite the initial plastic muscular cell incompetence, there are only small changes in their ultrastructure and myofibril contracture in the pre-occlusion period, which subside by the end of long-term (up to 37 min) occlusions. For the myocardium, reperfusion is the most damaging, but the damages, though widely diverse, are regarded mainly as moderate and reversible. Over again the electron microscopic finding provide good evidence for the feasibility of performing complicated cardiac surgeries with prolonged reversible exclusion of blood circulation under non-perfusion hypothermia.

Adult↗
PubMed1989

[Characteristics of the adrenocortical reaction of a heart valve prosthesis during non-perfusion hypothermal protection].

Correction of acquired diseases of the heart performed under conditions of nonperfusion hypothermal defense (29-28 degrees C) in 68 patients was followed by a moderately pronounced adreno-cortical reaction reaching its maximum in the period of heating and having a tendency to decrease on the third day after operation. The absence of a pronounced relationship between the degree of growth of 11-OCS in plasma, duration of occlusion and continuation of the restorative period confirm the adequacy and effectiveness of the method of hypothermal defense in prosthesis of the heart valves.

11-Hydroxycorticosteroids↗
PubMedDate not supplied

[Open-heart surgery without the use of donor blood].

Blood transfusions were not performed intra- or postoperatively in 10 patients operated on for acquired heart valve defects under perfusion-free hypothermia (PFH). The otherwise favourable postoperative period was characterized by a moderate decrease in hemoglobin level and red blood cell count. No complications have been observed. It has been concluded that the volume of the blood transfused can be considerably reduced or in some cases there can be no transfusions at all during surgery under PFH.

Adult↗
PubMedDate not supplied

[A case of long-term occlusion in craniocerebral hypothermia].

A case of urgent application of craniocerebral hypothermia (CCH) during correction of traumatic mitral insufficiency developing in the course of closed mitral commissurotomy is described. The occlusion duration was 46.5 min, with the temperature in the esophagus 30.2 degrees C. No postoperative neurological disturbances have been observed. Three years after surgery the patient was in a satisfactory condition. It is demonstrated that CCH is associated with a more marked antihypoxic effect, than it has been earlier believed, and that it is possible to use intravenous ketamine anesthesia during CCH in patients with low cardiac output syndrome.

Adult↗
PubMedDate not supplied

[Early neutralization of heparin during heart surgery of acquired heart defects using perfusion-free hypothermia (28-24C)].

The analysis of blood loss in profound perfusion-free hypothermia has shown that its main cause is that heparin neutralization was performed only after the warming of a patient to 34-35 degrees C. The results of in vitro studies have shown that heparin was effectively neutralized by protamine sulfate at room temperature (20 degrees C). Using protamine sulfate, heparin neutralization was performed at 25-27 degrees C in 90 patients, which reduced blood loss by 10-15% of the circulating blood volume and made it possible to avoid hemotransfusions in the post-operative period.

Cardiac Surgical Procedures↗