RESUMEN
The article deals with the results of complex study of the effect of pulmonary insufficiency on intracardiac hemodynamics and function of the heart in the immediate and late-term periods after radical correction of Fallot's tetralogy. Answers are also given to questions concerning the expediency of the use and functional adequacy of a xeno-pericardial monocusp in the closure mechanism of the pulmonary artery valve. The study showed that massive pulmonary regurgitation has a negative effect on the functional condition of the right ventricle in late-term postoperative periods. Convincing data were obtained which allow a graft with a monocusp of a bull's pericardium to be recommended for further clinical use to prevent insufficiency of the pulmonary artery valve after radical correction of Fallot's tetralogy.
Asunto(s)
Pericardio/trasplante , Tetralogía de Fallot/cirugía , Animales , Gatos , Electrocardiografía , Estudios de Seguimiento , Humanos , Modelos Biológicos , Complicaciones Posoperatorias/prevención & control , Válvula Pulmonar/cirugía , Insuficiencia de la Válvula Pulmonar/prevención & control , Factores de TiempoRESUMEN
21 patients have been monitored after open heart surgery. Clinical and model analysis of the genesis of statistical interrelations between the cardiac index (CI) and left ventricular (Plv) and right ventricular (Prv) filling pressure has been performed. It has been shown that CI dependence on Prv or Plv is characteristic of the cardiac performance only in case CI variation is mainly associated with changes in the preload. CI variations are caused mostly by changes in the corresponding half of the heart, while CI dependence on Prv (Plv) does not characterize the heart function and is not Frank-Starling's curve, with the value and angle of the regression slope failing to reflect the degree of the heart pump function damage. It is concluded that in most cases it is practically impossible to assess the cardiac function by the shape of Frank-Starling's curves in intensive care wards.
Asunto(s)
Gasto Cardíaco , Unidades de Cuidados Intensivos , Monitoreo Fisiológico/métodos , HumanosRESUMEN
General theoretical aspects (classification of circulatory disorders and heart failure) and results of research into specific subdivisions of cardiovascular and respiratory system pathology in cardiac surgical patients are discussed. The material is aggregated by the applied clinico-mathematical approach that has been developed and introduced into clinical practice in the recent 15 years at the Bakulev Institute of Cardiovascular Surgery. The extension of the clinico-mathematical approach onto the intraoperative control and analysis of the patients' status, assessment of the anaesthetic administration and cardioplegic protection is first overviewed.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Enfermedades Cardiovasculares/etiología , Insuficiencia Cardíaca/etiología , Complicaciones Intraoperatorias , Complicaciones Posoperatorias , Enfermedad Aguda , HumanosRESUMEN
Both single or repeated (during 14 days) administration of sodium ribonucleate (10 mg/kg) into rabbits, caused an increased formation of lysine-RNA, leucine-t-RNA and alanine-t-RNA; At the same time, the acceptive capacity of t-RNA and aminoacylating activity of amino acyl-t-RNA-synthetases were increased. In sceletal muscles these processes were unaltered after single administration of sodium ribonucleate, but were stimulated after the repeated injections.