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A A Spiridonov

Publications and source records attributed to A A Spiridonov.

At least 19 recordsLinked to original sources
PubMed2004

[A case of successful one-stage correction of abdominal aortic aneurysm and stenosis of the internal carotid artery in a 78-year-old patient].

Presented herein are the results of successful one-stage revascularization of the brain and reconstruction of the abdominal aorta in a 78-year old patient with infrarenal abdominal aortic aneurysm, the signs of rupture, stenosis of the left renal artery and multiple aortic arch lesions -- stenoses of both internal carotid arteries and both vertebral arteries. The sequence and technology of surgical intervention are described.

Aged↗
PubMed2004

[Effect of aortic clamping on hemodynamics at reconstruction of the thoracoabdominal aorta].

This paper describes an experience with monitoring and computerized follow up of the hemodynamic status in 60 patients at and right after reconstruction of the thoracoabdominal aorta. In addition to the routine control, measurements were made of the pressure in the large vessels and cavities of the heart, duration of each heart contraction and CI. The following parameters were computed automatically: the status of the ventricles for each heart contraction, resistance of the greater end pulmonary circulation, elasticity of the arterial, venous, pulmonary arterial and pulmonary venous reservoirs, also for each cardiac cycle. At the generally accepted monitoring the hemodynamic responses to the surgeon's manipulations on the aorta appear smoothed or are not visualized at all. The control of each heart contraction reveals the responses to application of the clamp and its removal from the aorta, with their hemodynamic significance being not questionable. Aortic clamping and clamp removal from the aorta are associated with the generalized response of the regulatory systems of the body. The slow and thoroughly controlled aortic clamping and graded, controlled blood flow restoration due to clamp removal as well as the use of sodium nitroprusside (trimetafan or isofluran are preferable) allow to avoid an abrupt stroke load of the left ventricle of the heart and, respectively, the generalized response of the regulatory systems of the body.

Aortic Aneurysm, Abdominal↗
PubMed1996

[Aortic coarctation and the bicuspid aortic valve].

After the analysis of the long-term outcomes of aortic coarctation isolated resection the authors noted that many of the patients had valvular defects missed for diagnosis before the operation. ECG and X-ray of the heart established valvular defects in 37% of the operated patients. 61% of them had bicuspid valve associated in 80% of cases with pathologically dilated ascending aorta. Correlation-regression analysis showed the existence of a significant correlation between the width of the ascending aorta and age of the operated patient. This width in bicuspid valve patients was correlated with systolic and diastolic pressure, physical performance before surgery. Follow-up of patients after resection of aortic coarctation should be especially careful for patients with bicuspid aortic valve with dilatation of the ascending aorta and high arterial pressure.

Adolescent↗
PubMed1993

[The efficacy of the surgical treatment of occlusive lesions of the carotid arteries].

The authors from the A. N. Bakulev Institute of Cardiovascular Surgery analyze the results of surgical management of 154 males aged 40-60 years who suffered from carotid artery occlusions. The patients were divided into three groups of patients: (1) 28 patients with asymptomatic occlusions; (2) 36 with transient ischemic episodes (TIE), and (3) 90 with ischemic stroke. A set of techniques was used, which involved Doppler ultrasonography with spectral analysis of a Doppler ultrasonographic signal, study of regional brain blood flow from brain tissue 133Xe clearance by using the functional hypercapnic test, computed tomography and angiography. A total of 165 operations were performed. The outcomes of surgical management in the early postoperative period were studied in all patients. The long-term outcomes were analyzed in 130 patients who had been followed up for average 2.3 years. In the immediate postoperative period, the uncomplicated course was in 96.4% from Group 1, in 96.3% from Group 2, and in 94.4% from Group 3. Deaths occurred in 1.3%. In the late period, all patients from Group 1 had no signs of cerebrovascular insufficiency, an improvement was observed in 88.9 and 80.0% in Groups 2 and 3, respectively. No deaths occurred in all the groups in the late postoperative period. The paper discusses how the efficiency of surgical management is related to the cerebral hemodynamics and morphological changes in brain tissues in carotid artery occlusions.

Adult↗
PubMed1992

[Methods of plastic surgery of the renal arteries in children with vasorenal hypertension].

The work deals with the management of vasorenal hypertension in children and adolescents. The Bakulev Institute of Cardiovascular Surgery had 185 children with arterial hypertension from 1965 to 1990. Their ages ranged from 12 months to 17 years. The vasorenal genesis of hypertension was caused by fibromuscular dysplasia (FMD) of the renal arteries in 61 patients, unspecific aortoarteritis (UAA) in 39, hypoplasia of the abdominal aorta, kidneys, and renal arteries in 22 patients, supernumerary renal arteries were found in 7 patients. A total of 119 operations were carried out on 106 patients. Operations and one-stage revascularization of the kidneys and alimentary organs were performed on 22 patients, isolated reconstruction of the renal arteries on 51 patients. Among 99 patients with stenoses and aneurysms of the renal arteries 13 were treated by nephrectomy (11.3%). The postoperative mortality was 0.9%. A hypotensive effect was not produced in the immediate postoperative period in 5 patients with UAA (4.6%) and in one patient with, FMD (0.9%). Six operations were performed in late-term periods after the first operative interventions: 2 for aneurysm of autovenous grafts, 2 for restenosis of the renal arteries, and 2 for stenosis of the aorta distal to the primary site of reconstruction in UAA. Three patients died in the late-term periods. The stability of good operative results was highest in congenital hypoplasia of the aorta--100%. A favorable effect of the operation persists in 89.6% of patients with FMD of the renal arteries. The stability of the effect is lowest (75%) in UAA.

Adolescent↗
PubMed1992

[Arterial hypertension in the late period after the hemodynamically adequate correction of aortic coarctation].

The paper is concerned with a study of arterial hypertension in the long-term periods after the resection of coarctation of aorta in 77 patients aged 6 to 35 years. The complex of the patients' examination included bicycle ergometry. Arterial hypertension was revealed in 59.7% of the patients. In 83.2%, adequate correction was performed, in 16.8%, recoarctation was suspected. The rate of the development of hypertension in the operated under 16 years depends on the grade of the systolic AP increase before the operation. In those operated on in the older age, the rate of arterial hypertension depended on the time elapsed after the operation and the age by the moment of examination. In 50% of arterial hypertension patients, the work fitness corresponds to that in healthy subjects, in 28%, it constitutes 75% of the level seen in healthy subjects, and in 22%, it is low. Indications for operation in persons under 16 years rest on the grade of the arterial pressure increase; in the older age, indications are not dependent on the arterial pressure level.

Age Factors↗
PubMed1992

[Selective screening for abdominal aortic aneurysms by using the clinical examination and ultrasonic scanning].

The results of screening for asymptomatic abdominal aortic aneurysms (AAA) in patients with great artery lesions and arterial hypertension (n = 163) are analyzed in the paper. Ten aneurysms were detected. These included 9 fusiform aneurysms, mean 43 +/- 3 mm in diameter and 1 ampullar one, 32 x 33 mm. The prevalence of abdominal aortic aneurysms was 7.2% in the risk group. It is concluded that palpation is of low informative value in the detection and differential diagnosis of asymptomatic abdominal aortic aneurysms of small diameter and in this respect ultrasonic scanning is of high informative value. It is concluded that the target-oriented screening for abdominal aortic aneurysms is essential and cost-effective in angiological patients, especially in concomitance of chronic lower extremity ischemia and arterial hypertension, as well as in patients with thoracic aortic aneurysms (except for posttraumatic ones).

Adolescent↗
PubMed1991

[Simultaneous reconstructive operations in combined lesions of the coronary arteries, abdominal aorta and arteries of the lower extremities].

The work deals with the results of one-stage reconstructive surgical interventions in 15 patients with affection of the coronary arteries, abdominal aorta, and lower limb arteries. All patients underwent operation for the creation of an aortocoronary shunt in combination with various types of vascular reconstructive operations, including the formation of an ascending aorta -bifemoral shunt in 3 patients. The total hospital mortality was 26.7%. The authors discuss the indications and the surgical tactics of one-stage reconstructive interventions in combined affection of the coronary and peripheral arteries.

Anastomosis, Surgical↗
PubMed1991

[Tactics of the surgical treatment of combined occlusive diseases of the coronary arteries, the abdominal aorta and the arteries of the lower extremities].

On the basis of experience in reconstructive operations on 250 patients with combined affection of the coronary arteries, abdominal aorta, and arteries of the lower limbs the authors discuss the diagnostic and tactical features of surgical management of these patients. The article dwells upon the necessary preoperative diagnostic algorithm as well as that in tactical variants of surgical treatment: (1) one-stage reconstructive operations on several vascular beds; (2) successive stage-by-stage treatment of patients with combined vascular pathology; (3) reconstructive vascular intervention on only one of the vascular beds. Correct practical solution of all these problems allowed the authors to reduce postoperative lethality to 5.4% among this grave contingent of patients with combined vascular pathology.

Aorta, Abdominal↗
PubMed1991

[Right aortic arch with a retro-esophageal diverticulum (embryology, anatomy, classification, clinical picture, diagnosis and surgical treatment)].

Five clinical cases (adult patients) are discussed in illustration of the problems of embryology, anatomy, clinical picture, and X-ray and angiographic diagnosis of a rare anomaly, right arch of the aorta (RAA) with retro-esophageal diverticulum of the aorta. According to I. J. Garti's classification, type C RAA was determined in 4 patients and type B RAA in one patient. The vascular ring around the esophagus and trachea was manifested clinically by mild respiratory disorders in 2 and marked dysphagia in all 5 patients, which required surgical correction. Four patients were operated on through a left posterolateral thoracotomy in the fourth-fifth intercostal space, one patient through a bilateral approach with division of the sternum on the level of the third intercostal space. The clinical effect of the operation was good in all patients. The indications for and the tactics of surgical treatment are discussed.

Adult↗
PubMed1990

[Surgical treatment of nonspecific aorto-arteritis].

The authors analyse experience with 273 operations carried out in 273 patients; 107 operations were conducted on the branches of the aortic arch, 136 were performed for the "middle aorta syndrome", and 30 operations were performed in affections of the terminal aorta and the iliac arteries. Experience is also shown in operative treatment of 32 patients with coexistent affections of the "middle aorta" and the branches of the aortic arch, the surgical tactics and the sequence of operations in this type of pathology are discussed. Problems dealing with the classification of nonspecific aorto-aortitis (NAA) are discussed, and the authors' classification of the variants of the vascular manifestations of the process is suggested. The authors draw attention to the need for preoperative management of patients with UAA for correcting the activity of the inflammatory process. Hemosorption and immunocorrective therapy are suggested for this purpose. Means for improving the results of surgical treatment of patients with UAA are suggested. The total mortality was 13%.

Adult↗
PubMed1990

[Causes of death in patients with coarctation of the aorta operated on after the age of 35].

The article analyses the causes of death of 60 patients with coarctation of the aorta who were operated on after the age of 35 in the period between 1962 and 1988. In the immediate postoperative period the mortality was 8.3%. Fifty-one patients were examined in late-term postoperative periods of up to 24 years. Twelve (23.5%) patients died from cardiovascular diseases; ischemic heart disease was found in 39.2% and residual hypertension in 41.2% of cases. Eight gross preparations of the hearts of patients who died at the clinic were examined with histological study of the myocardium and coronary vessels.

Age Factors↗
PubMed1990

[New aspects of the surgical treatment of aortic coarctation].

The article substantiates the urgency of the problem and shows the results of surgical treatment of coarctation of the aorta in 103 patients who were operated on in the recent 5 years. The operation of choice was resection of the coarctation with the formation of an end-to-end anastomosis (90.3% of operations). Establishment of the anastomosis by methods developed at the department makes it possible to achieve good results and avoid complications in the immediate and late-term postoperative periods. An anomalous arterial branch, a reduced branch of the 5th aortic arch called Abbott's artery, was ligated in 40% of cases. No fatal outcomes occurred in the last 5 years in surgical treatment of coarctation of the aorta.

Adolescent↗
PubMed1990

[Selection of the method of renal revascularization in arteriosclerosis of the renal arteries].

The work has analyzed results of 91 transaortal endarterectomies and 66 prostheses of renal arteries with the autovein. A preliminarily arterialized autovein is proposed as an autotransplant. The arterialization is achieved by inclusion of the autovein in the peripheral arterial system where the vein is gradually transformed and within 10-12 weeks its structure and biomechanical properties become closer to those of the artery of the musculo-elastic type. Preliminary arterialization excludes dilatatory changes of the autovenous transport.

Adult↗
PubMed1990

[The "steal" syndrome in patients with occlusive diseases of the aorta and iliac arteries].

In the work, the findings of clinical, functional and angiographic investigations in patients with the "steal" syndrome are systematized. In 39 of the 152 patients with atherosclerosis of the vessels of the aortoiliofemoral segment, the two forms of the "steal" syndrome (external iliac and pelvic "steal") causing the arterial erectile impotence were revealed. For objectivization of the syndrome, a test of "coitus loading" on the muscles of the lower extremities was used.

Adult↗
PubMed1990

[Effect of lumbar sympathectomy on late results of reconstructive operations on the abdominal aorta and arteries of the lower extremities].

The use of reconstructive operation in combination with lumbar sympathectomy for the treatment of obliterative lesion of the vessels of the aortoiliofemoral segment permits to reduce the incidence of development of the early postoperative vascular thrombosis and late reocclusion. A good patency of vascular transplants after combined operation was noted in 62% of cases, after isolated reconstruction--in 38%.

Aorta, Abdominal↗
PubMed1990

[Present-day vascular surgery--unsolved problems].

With the establishment in the USSR of the ALL-Union Society of Cardiovascular Surgeons, a section of angiology at the All-Union Society of Cardiologists, and sections of heart and vascular surgery at the All-Union Society of Surgeons, the necessity of consolidating the efforts of all these organizations to advance and intensify the scientific and practical work in rendering adequate and effective aid to patients with vascular diseases must be recognized. Twenty-two thousand reconstructive operations were performed on the aorta and great arteries in the USSR in 1987. The main trends in vascular surgery in the USA and USSR were analysed; insufficient attention to such problems as surgery of the branches of the arch of the aorta and aneurysms of the abdominal aorta was pointed out, the need to intensify training of new angiosurgeons in the country and increase two- to threefold the number of operations performed by each one of them (to 100 reconstructive operations carried out by each surgeon annually) was substantiated. The experience of the Bakulev Institute of Cardiovascular Surgery is shown in illustration of the main organizational measures which allow the number of reconstructive operations in the cardinal branches of angiosurgery to be increased twofold. The following should be considered the main branches of angiosurgery: surgery of multifocal atherosclerosis, branches of the arch of the aorta, aneurysms of the aorta, and surgery in thromboembolism of the pulmonary arteries, reconstructive operations in injury and acute thrombosis of the great arteries, radiologically-guided surgery for recanalization of arteries and creation of new thromboresistant vascular prostheses.

Adult↗