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There was compared the occurrence frequency of the acute cardiac insufficiency, acute myocardium infarction, acute disorder of cerebral blood circulation, disorders of cardiac rhythm and conduction and other perioperative complications in patients of three groups, operated on using artificial blood circulation, in whom the cardioplegic solution, prepared according to different methods, was used. It is recommended not to permit the crystallization (freezing) of isotonic sodium chloride solution occurrence, used for cardioplegia and for flooding to the pericardium cavity also to cool the heart externally.

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One hundred and thirty five children have been examined after surgery for congenital heart valve defects performed under ketamine anesthesia. It has been established that ketamine anesthesia has no considerable effect on the preload and cardiac pump function. Different hemodynamic changes have been observed in systemic and pulmonary circulation: the afterload of the left ventricle increases, while the afterload of the right ventricle decreases, which causes an increase in the heart performance (and energy consumption) in the first case and their reduction in the second case. In ketamine anesthesia myocardial contractility is enhanced and relaxation is deteriorated, and the tone of arterial vessels in the kidneys, bulbar conjunctiva, and skeletal muscles is increased. A spasm in the vessels of the conjunctiva is observed even when small drug doses are used. This may be accounted for by calcium accumulation in the muscular cells, noradrenaline hyperproduction, enhanced sensitivity of sympathomimetic receptors to circulating endogenous catecholamines.

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The effect of various N2O concentrations on oxidation-phosphorylation, content and relationship of cytochromes in heart, liver, kidney and brain mitochondria and ATP-ase activity of myocardial actomyosin has been studied in the experiments on 180 white rats. It has been shown that N2O has distinct effect on oxidation-phosphorylation in mitochondria of the above organs. The most marked changes were observed in the myocardium and liver. However, the inhibition of tissue respiration noted and the rate of phosphorylation was not accompanied by a decrease in phosphorylation efficacy, which is indicative of great reserves of the mitochondrial oxidation chain and the reversibility of the occurring shifts. The absence of shifts in cytochrome system in response to the inhibition of mitochondrial oxidation in different conditions demonstrate that metabolic effect of N2O is manifested in NAD-dependent regions of the respiratory chain.

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Calipsol has no significant effect on the preload, cardiac pump function and systemic arterial pressure. Patients with congenital heart valve defects under calipsol anesthesia reveal different hemodynamic changes in systemic and pulmonary circulation; left ventricular afterload is increased, which leads to an enhancement in left ventricular work. The type of general anesthesia under study decreases right ventricular afterload and right ventricular work. The deterioration in myocardial relaxation in patients with congenital heart valve defects is accompanied by the improvement of myocardial contractility, which necessitates different approaches to calipsol administration in patients with cyanotic and acyanotic heart valve defects.

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Radioimmunoassays of plasma C-peptide, and plasma and erythrocyte insulin were made in mixed venous-arterial blood specimens of normal children and those with congenital heart diseases. In all cases, insulin level was higher in erythrocytes, as compared to plasma specimens, obviously due to active insulin deposition by erythrocytes. Venous-arterial difference in insulin may be indicative of tissue insulin uptake. Respiratory and circulatory hypoxia is associated with decreased erythrocyte capacity for insulin deposition and tissue insulin uptake. It is suggested that plasma C-peptide content may be an indicator of pancreatic function.

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Nitrous oxide was discovered to have different effects on oxidative phosphorylation of heart, liver, kidney and brain mitochondria. The most demonstrable changes were found in the myocardium and liver. An increase in the anesthetic concentration provoked a more considerable inhibition of the rate of oxygen consumption in different metabolic states and of the phosphorylation rate of liver and myocardial mitochondria. High doses of nitrous oxide were found to inhibit ATPase activity of myocardial actomyosin. The action of the anesthetic on the brain manifested in the inhibition of the phosphorylation rate, that on the kidneys in the increased rate of free oxidation.

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Patients with acquired heart defects show oxidative phosphorylation disorders and reduced actomyosin ATPase activity. The markedness of changes is proportionate to the severity of valvular lesion as well as heart and myocardial failure. A relationship is demonstrated between disorders of energy generation and utilization, and contractility changes in the myocardium.

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