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A I Gorchakova

Publications and source records attributed to A I Gorchakova.

17 recordsLinked to original sources
PubMed1991

[Criteria of the operability of patients with a common arterial trunk based on hemodynamic data].

Criteria of operability of patients with a common arterial trunk were evaluated from a complex of hemodynamic, clinical, and morphological data. The patients were divided into 2 main groups according to the value of the pulmonary blood flow (PBF): group 1 with the pulmonary to systemic blood flow ratio (PBF/SBF) greater than 1; group 2 with PBF/SBF less than 1. The indications for operation in group 1 depended on the degree of PBF increase. For instance, an operation was indicated for patients with marked increase of PBF (PBF/SBF greater than 2); in cases with moderate PBF growth [formula: see text] the indications for operation were determined only after additional lung biopsy. The operation was not indicated for group 2 patients (PBF/SBF less than 1.0) because of the severity of their condition due to obstructive pulmonary vascular disease.

Adolescent↗
PubMed1990

[Anatomic correction of solitary left heart ventricle with left-sided transposition of the aorta].

A complex approach in determining the indications for radical correction of a solitary ventricle (SV) is discussed and the specific features of the operation and its results are shown. Radical correction of a SLV with levotransposition of the aorta was carried out in 4 patients one of whom died. The anatomy and function of the valves, the volume and functional characteristics of the SV, and the condition of the subaortic tract were studied in all patients before the operation. Diagnostic biopsy of the lung was undertaken in 3 cases to specify the character of pulmonary hypertension. To reduce the pliancy of the artificial interventricular septum (AIVS) and prevent bulging of the graft into the venous ventricle the method of the operation included: (a) creation of the AIVS from a duplicate of xenopericardium or Dacron whose dimensions were calculated before the operation; (b) plastic distention of the created venous ventricle by means of a graft. Complete atrioventricular block occurred after the operation in 1 patient and sinus rhythm in 2 patients. The patients are in a good condition corresponding to NYHA class 1 (2 patients) and 2 (1 patient) and lead an active live.

Abnormalities, Multiple↗
PubMed1990

[New approach to the selection of the method of corrective surgery in single heart ventricle].

The work deals with choice of the optimal method for correction of a single heart ventricle. With this in view, the authors studied the anatomy and function of the atrioventricular valves, the volumetric and functional characteristics of the single ventricle, and the condition of the central parts of the pulmonary artery and the subaortic tract in 46 patients with various anatomical forms of the anomaly. Analysis of the results not only helped in specifying the indications for the use of one or another method of correction of the single ventricle but made it possible to determine the optimal volume of the chosen method according to the anatomo-hemodynamic variant of the anomaly and the condition of the vessels of pulmonary circulation. By means of the approach discussed in the work, 4 operations were carried out for forming an artificial interventricular septum and 14 operations for hemodynamic correction in patients with stenosis of the pulmonary artery.

Abnormalities, Multiple↗
PubMed1986

Pulmonary arterial changes in patients with ventricular septal defects and severe pulmonary hypertension.

In 25 patients, aged eight months to 31 years, with ventricular septal defect (VSD; isolated in 15, the others with atrial septal defect, PDA, coarctation or patent ductus arteriosus + coarctation), each with severe pulmonary artery hypertension (pulmonary artery systolic pressure [Ppa] at least 75% of systemic and an elevated pulmonary vascular resistance), we related morphologic and morphometric data from open-lung biopsy to hemodynamic measurements obtained at cardiac catheterization during the same hospital admission. Of the hemodynamic features measured, only the ratios of pulmonary-to-systemic flow and pulmonary-to-systemic resistance correlated significantly with structure. Neither pulmonary artery pressure (Ppa) nor pulmonary vascular resistance correlated significantly with any structural feature studied. The increased external diameter of respiratory bronchiolar arteries in those with the more advanced Heath-Edwards grades reflects dilatation and suggests that it is in the small arteries of the distal arterial bed that the changes of pulmonary hypertension are most significant. Neither age nor body weight correlated significantly with the degree of structural or hemodynamic abnormality. In the ten patients who underwent VSD closure, Ppa was measured postoperatively. The Heath-Edwards grade (no more than one grade-III lesion) and arterial density (at least one-half that normal for age) were the best correlates of the difference between preoperative Ppa and Ppa immediately after corrective surgery. The presurgical catheterization data, including pulmonary resistance and the resistance ratio, did not correlate significantly with change in Ppa following VSD closure.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1984

[Role of lung biopsy in a heart surgery center (a new method for the quantitative assessment of pulmonary hypertension by biopsy of the lung of patients with congenital heart defects)].

Forty-three lung biopsies taken from 42 patients with various congenital heart malformations with high pulmonary hypertension (aged from 8 months to 34 years) were studied by morphological and morphometric methods. Changes in the pulmonary vessels were evaluated according to Heat-Edwards' classification and morphometric classification of Rabinovitch , et al. The morphometric data give some additional information on the growth and development of peripheral vessels, the degree of hypertrophy of tunica media muscularis, a decrease in the size of arteries. The demonstration of considerable reduction in the number of peripheral arteries by morphometry constitutes a serious prognostic sign of further progression of sclerotic changes in the pulmonary vessels even in the early correction of the heart malformation.

Adolescent↗
PubMedDate not supplied

[Modern computer data base "necropsy protocol": potential and prospects].

Basic principles in developing computer variant of necropsy protocol with wide illustrative possibilities are presented. Perspectives in the use of this information base for research and practice and for teaching the staff of the research and clinical institutions are demonstrated.

Autopsy↗
PubMedDate not supplied

[Changes in pulmonary vessels in complicated congenital valvular defects with high pulmonary hypertension].

349 cases of morphological alteration of pulmonary vessels with complex inborn heart defects (major vessels transposition with intraventricular septum deficiency, Taussig-Bing anomaly, double vessels departure from the right ventricle, common arterial trunk, single heart ventricle) were studied by the time and growth speed of structural vascular changes of lung circulation in correspondence with classification of Heath-Edwards. It is established that formation of morphological changes of pulmonary vessels in those defects takes place during the first half of year of patient life. Most malignant vascular changes occur in common arterial trunck and transposition of major vessels with a defect of the interventricular septum. A isolated defect of interventricular septum, single ventricle, double departure of vessels from the right ventricle show a relatively favourable course of the disease.

Child↗