RESUMEN

A comprehensive angiocardiographic study with computer-aided data processing were performed in 46 patients (mean age 34.2 years) with multivalvular diseases. Thirty two patients were diagnosed as having mitral and aortic defect, 14 had mitral, aortic and tricuspid defect. Three-valve disease, unlike two-valve disease, showed a "paradoxical" improvement in some parameters, such as end-diastolic volume, end-systolic volume, myocardial mass, ventricular performance rates. An analysis of circular intramyocardial tension, coronary sinus blood oxygen extraction and saturation indicated that myocardial function was less intensive in three-valve disease, suggesting the compensatory pattern of tricuspid valve involvement. However, this "compensation" results in a further decrease in cardiac output and cannot be regarded as a genuine compensation. In multivalvular disease, the integral intramyocardial tension and its ratio to coronary sinus blood oxygen saturation may serve as the only diagnostic criterion for myocardial dysfunction and a predictor in determining the outcome of surgical intervention.

Asunto(s)

Asunto(s)

RESUMEN

Operations for aorto-coronary shunting and mammary-coronary shunting on a working heart were carried out without the use of a heart-lung machine in 19 patients with various forms of unstable angina pectoris in early periods (7 to 30 days) after the onset of the disease and in high left-ventricular end-diastolic pressure. There were no fatal outcomes. The post-operative follow-up periods ranged from 4 weeks to 2.5 years.

Asunto(s)

RESUMEN

A complex angiographic examination was performed in 28 patients with rheumatic aortic valvular disease. The major mechanism of compensation in aortic failure was found to be an increase in left ventricular end-diastolic volume at the expense of added regurgitating blood volume. It was shown that isolated aortic failure was a good compensated defect with high functional myocardial reserves and coronary circulation along with adequate left ventricular dilatation and normal-stress nature of left ventricular hypertrophy. Left ventricular dilation at a regurgitation fraction of less than 30% and intramyocardial tension increase were demonstrated to be unfavorable predictive signs and to be indicative of profound myocardial dysfunction.

Asunto(s)

Asunto(s)

RESUMEN

The paper describes the procedure developed by the authors for surgical myocardial revascularization in patients with coronary heart disease (CHD) via direct reconstruction of the ostium and all the segments of the right coronary artery by performing direct endarterectomy and subsequent plasty with free autopericardial flaps. The findings indicate that this surgical method is beneficial for CHD patients. In some cases, it may be the method of choice in the surgical treatment of CHD patients.

Asunto(s)

RESUMEN

Aorto-coronary bypass were performed in 10 patients aged from 34 to 55 years 7 to 30 days after the occurrence of angina pectoris for the first time. Coronarography demonstrated stenosis (of more than 75%) of the coronary arteries in all patients. Angina pectoris disappeared and did not recur in postoperative periods of up to 12 months in all cases. Shuntography was carried out 6 weeks after the operation in one patient: the shunt was potent.

Asunto(s)

Asunto(s)

RESUMEN

The authors evaluate the efficacy of aortocoronary shunting in the treatment of 10 patients with progressive angina pectoris (unstable stenocardia) in follow-up periods of up to 12 months after the operation. In none of the patients did angina pectoris or myocardial infarction develop in the indicated postoperative periods.

Asunto(s)

RESUMEN

Aortocoronary shunting was performed in 15 patients with unstable and early postinfarction angina pectoris. Coronarography revealed an isolated lesion of a coronary artery in all the patients. Two years after the operation the patients had no angina pectoris; no myocardial infarctions occurred.

Asunto(s)

RESUMEN

Fourteen patients aged 34-54 years underwent aortocoronary bypass surgery for early postinfarction angina within 30 days following myocardial infarction. In periods up to 1.5 years after surgery, angina pectoris was not detected in the patients; cases of recurrent myocardial infarction were not registered.

Asunto(s)

RESUMEN

A method for prognosticating the degree of a hypotensive effect of revascularization of both kidneys was developed on a group of 22 patients with vasorenal hypertension caused by bilateral affections of the renal arteries. It was based on mathematical treatment by the method of multidimensional regressive analysis of some parameters of preoperative examination of the patient and allowed the postoperative arterial pressure value to be calculated in mm Hg.

Asunto(s)

RESUMEN

Parallel comparison of angiographic and morphologic indices of arterial nephrosclerosis levels was performed in 34 patients with vasorenal hypertension secondary to unilateral lesion of renal arteries. Coefficient of vascular picture absence zone in the kidney (30) presenting a percentage ratio of a vascular zone of kidney cortical layer and the total area of its section was employed. Amount of vascular index (ratio between the wall density of afferent glomerular arteriole and its lumen diameter) was used to assess arteriolosclerosis in morphologic examination of renal biopsy specimens. High level of reliable coefficient 30 in the evaluation of arteriolar nephrosclerosis degree was substantiated morphologically. Critical level of coefficient 30 was stated for the affected and contralateral kidneys, and its increase was suggestive of irreversible sclerosis of renal microvascular bed.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

The condition of coronary arteries and left-ventricular function were assessed in 62 patients with a history of myocardial infarction 1 month to 4 years prior to coronarographic investigation. It was demonstrated that the detectability of an occlusion in the artery supplying blood to the infarcted area decreased with time elapsed since myocardial infarction, the correlation being more characteristic of the anterior interventricular branch of the left coronary artery. An analysis of ventriculograms showed that myocardial infarction due to a lesion of the left coronary artery results in a smaller left-ventricular dysfunction and is less commonly associated with circulatory insufficiency. The frequency of spontaneous thrombolysis is shown to be relatively high in postmyocardial-infarction patients.

Asunto(s)

RESUMEN

A total of 154 patients with essential hypertension (EH), 24 patients with renovascular hypertension (RVH), and 130 Wistar rats were investigated. PGE2 and PGF2 alpha levels were assayed radioimmunologically in renal venous blood and urine of the patients, and the synthesis of PGE2 and PGF2 alpha in renal tissue, renal PGE-9-ketoreductase activity and urinary PG excretion were measured in rats. It was demonstrated that the PGE2 synthesis was depressed in the vascular channel and the renal uropoietic system, with elevated F/E rations, in patients with arterial hypertension. Clinical and experimental studies showed prolonged and excessive salt consumption to be a cause of these changes, rooted in suppressed renal biosynthesis of both PGs and increased conversion of PGE2 to PGF2 alpha. In addition, renal PGE2 inactivation was increased in EH patients, as compared to those with RVH. PGE2 produced in the kidneys of EH patients is always a depressor natriuretic substance, whereas the role of PGF2 alpha is dependent on the water-salt balance. Furosemide and, to a smaller extent, other diuretics, as well as some hypotensive agents, increase urinary PG excretion and depress the F/E ratio in the urine. Repeated PGE2 infusions are shown to enhance the sensitivity of EH patients to hypotensive drugs, so they can be used for the treatment of refractory EH cases.

Asunto(s)

RESUMEN

Twenty-one patients with congestive cardiomyopathy were examined by angiographic techniques. All the patients manifested a considerable decrease in the contractile and pump functions of the myocardium. The alterations were mainly diffuse in nature. However, the intensity of the hypokinesis of the different segments of the left ventricle was dissimilar. Morphological examination according to the endomyocardial biopsy data revealed the etiological heterogeneity of the group under study, which in addition to the patients with congestive cardiomyopathy proper comprised those with inflammatory and alcoholic lesions of the myocardium.

Asunto(s)

RESUMEN

The clinical picture and results of bicycle ergometry and selective coronarography were compared with data obtained by esophageal electric stimulation of the left atrium in 108 patients with suspected coronary disease. It was demonstrated that esophageal left-atrial electrostimulation could be used as noninvasive load test for coronary disease. Ischemic electrocardiographic changes, induced by esophageal stimulation showed good correlation to the clinical manifestation of angina pectoris and the severity of coronary atherosclerosis. The sensitivity of esophageal stimulation in the diagnosis of hemodynamically-significant coronary atherosclerosis was 82%, its specificity was 76%, the predictive value of positive results was 82%, and the predictive value of negative results, 76%, that is, essentially the same as the respective parameters of bicycle ergometry.

Asunto(s)

Asunto(s)